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<strong>Getting</strong> XALKORI®

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Filling your XALKORI (crizotinib) prescription
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You can get XALKORI through certain specialty pharmacies. Your healthcare provider’s office may help you fill your prescription through the specialty pharmacy.

Filling XALKORI® (crizotinib) Rx | Safety Info
Find information on filling a XALKORI® (crizotinib) prescription through certain specialty pharmacies.

XALKORI <strong>Financial Assistance</strong>

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Helping you get the medicine you need
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Pfizer Oncology Together
If you need help understanding your insurance or what financial support may be available, our Care Champions are here to help. We can also assist in finding the appropriate specialty pharmacy to fill your XALKORI prescription. Just give us a call—1-877-744-5675.

Select an insurance status

Commercially Insured?

Resources for eligible commercial, private, employer, and state health insurance marketplace patients

Making Sense of Your Coverage

We can help you better understand your insurance coverage and benefits. Based on your specific coverage, we can assist in finding the appropriate specialty pharmacy to fill your XALKORI prescription.

Co-pay Assistance

Eligible, commercially insured patients may pay as little as $0* a month for XALKORI.*

Enrollment is simple, with no income requirements, forms, or faxing. To be eligible, you must:

  • Be commercially insured (receive healthcare through your employer or pay for it on your own)
  • Not participate in any federal or state healthcare programs such as Medicaid and Medicare
Enroll now
*Limits, terms, and conditions apply. Patients may receive up to $25,000 in savings annually. The offer will be accepted only at participating pharmacies. This offer is not health insurance. No membership fees apply. For any questions, please call 1-877-744-5675, visit PfizerOncologyTogether.com or write: Pfizer Co-Pay One Savings Card, 2250 Perimeter Park Drive, Suite 300, Morrisville, NC 27560.

on Medicare or Government Insured?

Help identifying resources for patients with Medicare/Medicare Part D, Medicaid, and other government insurance plans

Making Sense of Your Coverage

We can help you better understand your insurance coverage and benefits. Based on your specific coverage, we can assist in finding the appropriate specialty pharmacy to fill your XALKORI prescription.

Support From Independent Charitable Foundations

Pfizer Oncology Together will assist patients with searching for financial support that may be available from independent charitable foundations. These foundations exist independently of Pfizer and have their own eligibility criteria and application processes. Availability of support from the foundations is determined solely by the foundations.

Free Medicine

If independent charitable foundation support is not available, Pfizer Oncology Together will provide eligible patients with XALKORI for free through the Pfizer Patient Assistance Program.

† The Pfizer Patient Assistance Program is a joint program of Pfizer Inc. and the Pfizer Patient Assistance Foundation. The Pfizer Patient Assistance Foundation is a separate legal entity from Pfizer Inc. with distinct legal restrictions.

Uninsured?

Help identifying resources for patients who do not have any form of healthcare coverage

Help Finding Coverage

Pfizer Oncology Together will check if you are eligible for a government program that helps pay for prescription medication through Medicaid or Medicare Part D. If you are eligible, we will guide you on how to apply and provide assistance throughout the entire process.

Free Medicine or Savings

If you do not have insurance or prescription coverage and you are unable to afford your medicine, we may be able to help. Pfizer Oncology Together can provide you with XALKORI for free or at a savings, if you are eligible, through the Pfizer Patient Assistance Program.

‡ The Pfizer Patient Assistance Program is a joint program of Pfizer Inc. and the Pfizer Patient Assistance Foundation. The Pfizer Patient Assistance Foundation is a separate legal entity from Pfizer Inc. with distinct legal restrictions.

 

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Terms and Conditions

By enrolling in this co-pay offer, you acknowledge that you currently meet the eligibility criteria and will comply with the Terms and Conditions described below:

  • This card is not valid for prescriptions that are eligible to be reimbursed, in whole or in part, by Medicaid, Medicare, Tricare or other federal or state healthcare programs (including any state prescription drug assistance programs) and the Government Health Insurance Plan available in Puerto Rico (formerly known as “La Reforma de Salud”).
  • This card is not valid when the entire cost of your prescription drug is eligible to be reimbursed by your private insurance plans or other health or pharmacy benefit programs.
  • With this card you will pay a $0 co-pay per eligible monthly prescription, subject to a maximum benefit of $25,000 per calendar year. The amount of any benefit is the difference between your co-pay and $0. After the maximum of $25,000 you will be responsible for the remaining monthly out-of-pocket costs. This card may be used once per 30 days until the maximum benefit has been reached. The average benefit is $924.21 per patient per year.
  • You must deduct the value of the benefit you receive with this card from any reimbursement request submitted to your insurance plan, either directly by you or on your behalf.
  • This card is not valid where prohibited by law.
  • Card cannot be combined with any other rebate/coupon, free trial or similar offer for the specified prescription.
  • Card will be accepted only at participating pharmacies.
  • This card is not health insurance.
  • Offer good only in the U.S. and Puerto Rico.
  • Card is limited to 1 per person during this offering period and is not transferable.
  • Pfizer reserves the right to rescind, revoke or amend this offer without notice.
  • No membership fee.
  • Offer expires 12/31/2019.
  • For reimbursement when using a nonparticipating pharmacy: Mail a copy of the patient’s pharmacy receipt indicating patient name, name of medication purchased, price paid, and date purchased, along with a copy of the patient’s Pfizer Co-pay One Savings Card, to:


    Pfizer Co-Pay One Savings Card
    2250 Perimeter Park Drive, Suite 300
    Morrisville, NC 27560

Savings & Financial Assistance | XALKORI® (crizotinib) | Safety Info
Read how eligible, commercially insured patients can pay no more than $10 a month for their XALKORI® (crizotinib) prescription. Limits, terms & conditions apply