Pfizer

Patient Support Services Guide 2018


Pfizer Oncology Together
877-744-5675

Pfizer Oncology Together is a patient support program that provides patients and providers access to reimbursement services, financial assistance services, and personalized patient support offerings. Patients may be eligible for different support service options based on their needs and on the Pfizer oncology medication they are prescribed.

The complete list of Pfizer oncology and oncology supportive care drugs and their indications and support programs is provided in the Table.

Pfizer Oncology Together

Patients with commercial insurance and prescription coverage who need assistance obtaining certain Pfizer medications may be eligible for one of the Pfizer Oncology Together programs. Patients who are prescribed Bosulif (bosutinib), Ibrance (palbociclib), Inlyta (axitinib), Sutent (sunitinib malate), or Xalkori (crizotinib) may be eligible for the Pfizer Co-Pay Savings Program.

Patients who are prescribed Besponsa (inotuzumab ozogamicin) or Mylotarg (gemtuzumab ozogamicin) may be eligible for the Pfizer Oncology Together IV Co-Pay Program. Patients who are prescribed Aromasin (exemestane) may be eligible for the Aromasin Savings Card.

Pfizer Oncology Together offers patients assistance with handling their benefits verification, prior authorization and appeals, and specialty pharmacy coordination.

For patients with Medicare coverage, including Part D, Medicaid, or other government insurance plans, Pfizer Oncology Together helps to identify financial support resources from independent charitable foundations. These foundations have their own eligibility criteria and application process, and availability of support is determined solely by the foundations.

The Pfizer Patient Assistance Program may be able to help patients to receive free medicine if independent charitable foundations are not available. Patients may also receive assistance in finding alternate insurance options. Eligible patients may receive up to a 90-day supply of the medicine until alternative options become available. Patients who are unable to secure insurance coverage may be eligible to receive their medication for free for up to 12 months.

For uninsured patients, Pfizer Oncology Together will help to determine patients’ eligibility for Medicaid or Medicare’s Low Income Subsidy, and will provide assistance with the application process.

Regardless of coverage status, the Free Trial Voucher program offers newly diagnosed patients who are prescribed Bosulif, Inlyta, or Sutent a free trial voucher, which they may get from their healthcare provider. The duration of the free trial is drug-specific (ie, Sutent, 14 days; Inlyta, 15 days; Bosulif, 30 days).

Eligibility

Pfizer Co-Pay Savings Program

Patients enrolled in this program will pay as little as $0 copay monthly for certain Pfizer medications (Table), with a maximum savings cap of $25,000 annually per patient. The copay savings card may be used once in 30 days until the maximum benefit has been reached. To be eligible for this program, patients must:

  • Reside in the United States or Puerto Rico
  • Have commercial insurance
  • Be aged >18 years.

The savings card is only accepted at participating pharmacies. This program is not valid for prescriptions that are eligible to be reimbursed, in whole or in part, by Medicaid, Medicare, TRICARE, or other federally or state-funded healthcare programs, or by private insurance plans or other health or pharmacy benefit programs. For more information, visit this website.

Pfizer Oncology Together IV Co-Pay Program

This program provides assistance for eligible, commercially insured patients for copays, coinsurance, or deductibles incurred for intravenous (IV) medications, up to $25,000 per calendar year. Patients may be able to pay as little as a $0 copay for their medication, but once their annual limit is reached, they are responsible for paying their copay in full. This program does not provide support for other physician-related services associated with treatment.

To be eligible for this program, patients must:

  • Reside in the United States or Puerto Rico
  • Be aged >18 years
  • Have commercial insurance that covers Besponsa or Mylotarg
  • Not be enrolled in a federally or state-funded insurance program.

This program has no income requirements.

Aromasin Savings Card

Patients enrolled in this program may pay as little as $4 for a 30-day fill and have a maximum monthly savings of $300, and an annual maximum savings of $3600. To be eligible for the program, patients must:

  • Be aged >18 years and reside in the United States or Puerto Rico
  • Have commercial insurance
  • Have prescriptions that are not eligible to be reimbursed by federally or state-funded programs, private insurance plans, or other health or pharmacy benefit programs.

Pfizer Patient Assistance Program

To qualify for enrollment in this program, patients must:

  • Have been prescribed a Pfizer Group B medicine by a qualified US physician
  • Reside in the United States, Puerto Rico, or the US Virgin Islands
  • Have no prescription drug coverage, or not enough coverage to afford a Pfizer medication
  • Meet income requirements that vary by medicine and by household size.

For more information about this program, call 844-989-7284 for new patients or 866-706-2400 for currently enrolled patients.

Application & Enrollment

Pfizer Oncology Together

To enroll in this program, patients must complete an enrollment form, and fax it to 877-736-6506.

Pfizer Co-Pay Savings Program

To enroll in this program and receive a Co-Pay One Savings Card, patients must complete a drug-specific enrollment form.

Pfizer Oncology Together IV Co-Pay Program

To enroll in this program, patients or their providers must submit a Pfizer Oncology Together enrollment form. On approval of the patient’s eligibility, the patient and the provider will receive approval letters with the IV Co-Pay Program group number and patient’s IV Co-Pay Program identification number, which are required for the submission of claims. Enrollment does

not guarantee copay assistance. Eligibility for a copay expense for the IV Co-Pay Program benefit will be determined at the time the benefit is paid.

Aromasin Savings Card

The Aromasin Savings Card may be requested by completing a form online, or by calling 866-562-6151.

Pfizer Patient Assistance Program

To enroll in this program, the prescriber must fax the completed application to 800-708-3430 or mail it to the address on the form, along with any other required documents.

Several documents must be submitted for income verification, including the previous year’s federal tax returns; paycheck stubs; wage and tax statements; Social Security, pension, or railroad retirement statements; and statements of interest, dividends, or other income.

After applying to this program, counselors will help patients identify and apply for alternate programs that can facilitate access to their medicine. These may be state drug assistance programs, copay foundations, or Medicare’s Low Income Subsidy. For information on participating pharmacies, call 866-706-2400.

Additional Services

In October 2017, Pfizer launched its new program, This Is Living With Cancer, which features the free mobile app LivingWith—designed to help patients to manage their lives with cancer. This program provides tools and resources to connect patients with their loved ones, provides help with daily living tasks, and improves communication with healthcare providers. This app also serves as a way to stay organized and keep track of questions and notes for physicians, reminders, and paperwork.

Pfizer Oncology/Oncology Supportive Care Drugs

Drugs
Indications
Patient support programs

Drug
Aromasin (exemestane tablets)
Indication
ER-positive early breast cancer; advanced breast cancer that progressed with tamoxifen

Drug
Besponsa (inotuzumab ozogamicin)
Indication
Relapsed or refractory B-cell precursor acute lymphoblastic leukemia

Drug
Bosulif (bosutinib)
Indication
Ph+ chronic myelogenous leukemia

Drug
Camptosar (irinotecan hydrochloride injection)
Indication
Metastatic colorectal cancer, alone or with 5-fluorouracil and leucovorin
Patient support program

Drug
Ellence (epirubicin hydrochloride injection)
Indication
Breast cancer adjuvant therapy in patients with evidence of axillary node tumor involvement after primary resection
Patient support program

Drug
Emcyt (estramustine phosphate sodium)
Indication
Metastatic and/or progressive prostate cancer
Patient support program

Drug
Ibrance (palbociclib)
Indication
HR-positive, HER2-negative advanced breast cancer

Drug
Idamycin PFS (idarubicin hydrochloride)
Indication
Acute myeloid leukemia in adults, with other antileukemic drugs
Patient support program

Drug
Inlyta (axitinib)
Indication
Advanced renal-cell carcinoma

Drug
Mylotarg (gemtuzumab ozogamicin)
Indication
Newly diagnosed CD33-positive acute myeloid leukemia in adults; relapsed or refractory CD33-positive acute myeloid leukemia in patients aged ≥2 years
Patient support program

Drug
Neumega (oprelvekin)
Indication
Stimulate platelet production in patients receiving certain types of chemotherapy
Product Details
View Product Details
(Patient support program unavailable)

Drug
Sutent (sunitinib malate)
Indication
GIST; advanced renal-cell carcinoma; neuroendocrine tumors of pancreatic origin

Drug
Torisel (temsirolimus)
Indication
Advanced renal-cell carcinoma
Patient support program

Drug
Xalkori (crizotinib)
Indication
Metastatic non–small-cell lung cancer with ALK or ROS1 mutations

Drug
Zinecard (dexrazoxane)
Indication
Reduce doxorubicin-induced cardiomyopathy in metastatic breast cancer
Patient support program

ER indicates estrogen receptor; GIST, gastrointestinal stromal tumor; HR, hormone receptor; IV, intravenous; Ph+, Philadelphia chromosome–positive.