Finding financial support options. Together.
We’ll help patients understand their benefits and connect them with financial assistance resources, regardless of their insurance coverage.
Get a guide to help you and your patients navigate healthcare coverage and financial support resources.
Commercially Insured
We can help identify financial assistance resources for patients with commercial, private, employer, and state health insurance marketplace coverage.
Co-Pay Assistance
Eligible, commercially insured patients may pay as little as $0 per month for the oral medications or per treatment for the injectable medications listed below through our co-pay savings programs. Limits, terms, and conditions apply.*
Access Patient Co-Pay Assistance
Select your patient's medication to find out if they’re eligible and to access co-pay assistance.
HCP copay form
*Required field.
Pfizer Oncology Together Co-Pay Program for IV
The Pfizer Oncology Together Co-Pay Program for IV (“IV Co-Pay Program”) provides eligible patients¶ with support for out-of-pocket drug costs, including co-pays, co-insurance, and deductibles. Limits, terms, and conditions apply.
HELP YOUR PATIENTS ENROLL
To get started, fax a completed enrollment form to 1-877-736-6506. Be sure to check the box for Intravenous (IV) Co-Pay Program and indicate if the patient will assign benefit to the healthcare provider.
For eligible, commercially insured patients¶
Co-pays may be as little as $0. Once the annual program limit is reached, the patient is responsible for the full co-pay.#
UP TO $25,000 PER CALENDAR YEAR
Program covers up to $25,000 per calendar year.**
No income requirements
There are no income requirements for patients to qualify.
OTHER RESOURCES
For information on claim submission or reimbursement processes, download the IV Co-Pay Program Brochure.
To submit claims by fax or mail, complete and fax the Co-Pay Claim Form to 1-908-809-6241.
For detailed instructions on Electronic Funds Transfer (EFT), Electronic Remittance Advice (ERA), or Electronic Data Interchange (EDI), go to the Forms & Resources page.
¶For patients to be eligible for the IV Co-Pay Program, they must have commercial insurance that covers BESPONSA™ (inotuzumab ozogamicin) or MYLOTARG™ (gemtuzumab ozogamicin) (each referred to as “Product”) and they cannot be enrolled in a state or federally funded insurance program. Whether a co-pay expense is eligible for the IV Co-Pay Program benefit will be determined at the time the benefit is paid. Co-pay expenses must be in connection with a separately paid claim for Product administered in the outpatient setting.
#The IV Co-Pay Program will pay the co-pay and any deductible obligations for the Product up to the annual assistance limit of $25,000 per calendar year per patient.
**The IV Co-Pay Program provides assistance for eligible, commercially insured patients for co-pays, co-insurance, or deductibles incurred for the Product, up to $25,000 per calendar year. It does not cover or provide support for supplies, services, procedures, or any other physician-related services associated with Product treatment.
Pfizer Oncology Together Co-Pay Savings Program for Injectables: ZIRABEV™ (bevacizumab-bvzr)
The Pfizer Oncology Together Co-Pay Savings Program for Injectables provides eligible, commercially insured patients prescribed ZIRABEV with support for out-of-pocket drug costs, including co-pays and coinsurance.
Limits, terms, and conditions apply. Patients prescribed ZIRABEV for certain conditions are not eligible for this co-pay savings program.
ELIGIBLE, COMMERCIALLY INSURED PATIENTS# MAY PAY AS LITTLE AS $0 FOR Each ZIRABEV TREATMENT**
- This program covers up to $25,000 per calendar year††
- There are no income requirements for patients to qualify
HELP YOUR PATIENTS ENROLL
To get started, fax a completed enrollment form to 1-877-736-6506, or fill out an enrollment form online through our provider portal. Be sure to fill out the section requesting enrollment in the Injectables Co-Pay Program and indicate if the patient will assign benefits to the healthcare provider.
OTHER RESOURCES
For information on enrollment, claims submission, and reimbursement, download the ZIRABEV co-pay savings program brochure below.
To submit claims, complete the claim form
below and send via fax or mail:
Fax: 1-973-843-1916
Mail: P.O. Box 10514, Fairfield, NJ 07004
To find additional co-pay program documents and information on the claims submission process, go to the Forms & Resources page.
CONTACT US FOR MORE INFORMATION
Pfizer Oncology Together or a local Pfizer Oncology Account Specialist can provide more information on this co-pay savings program. Give us a call at 1-877-744-5675 (Monday–Friday 8 AM–8 PM ET).
#For patients to be eligible for the Injectables Co-Pay Program for ZIRABEV, they must have commercial insurance that covers ZIRABEV™ (bevacizumab-bvzr) and they cannot be enrolled in a state or federally funded insurance program. Whether a co-pay expense is eligible for the Injectables Co-Pay Program for ZIRABEV benefit will be determined at the time the benefit is paid. Co-pay expenses must be in connection with a separately paid claim for ZIRABEV administered in the outpatient setting.
**The Injectables Co-Pay Program for ZIRABEV will pay the co-pays for ZIRABEV up to the annual assistance limit of $25,000 per calendar year per patient.
††The Injectables Co-Pay Program for ZIRABEV provides assistance for eligible, commercially insured patients for co-pays or coinsurance incurred for ZIRABEV, up to $25,000 per calendar year. It does not cover or provide support for supplies, services, procedures, or any other physician-related services associated with ZIRABEV treatment.
Pfizer Oncology Together Co-Pay Savings Program for Injectables: RUXIENCE™ (rituximab-pvvr)
The Pfizer Oncology Together Co-Pay Savings Program for Injectables provides eligible, commercially insured patients prescribed RUXIENCE with support for out-of-pocket drug costs, including co-pays and coinsurance.
Limits, terms, and conditions apply. Patients prescribed RUXIENCE for certain conditions are not eligible for this co-pay savings program.
ELIGIBLE, COMMERCIALLY INSURED PATIENTS# MAY PAY AS LITTLE AS $0 FOR each RUXIENCE TREATMENT**
- This program covers up to $25,000 per calendar year††
- There are no income requirements for patients to qualify
HELP YOUR PATIENTS ENROLL
To get started, fax a completed enrollment form to 1-877-736-6506, or fill out an enrollment form online through our provider portal. Be sure to fill out the section requesting enrollment in the Injectables Co-Pay Program and indicate if the patient will assign benefits to the healthcare provider.
OTHER RESOURCES
For information on enrollment, claims submission, and reimbursement, download the RUXIENCE co-pay savings program brochure below.
To submit claims, complete the claim form
below and send via fax or mail:
Fax: 1-855-631-0065
Mail: P.O. Box 10572, Fairfield, NJ 07004
To find additional co-pay program documents and information on the claims submission process, go to the Forms & Resources page.
Please see full Prescribing Information for RUXIENCE, including BOXED WARNING and Medication Guide, or visit RUXIENCEhcp.com.
CONTACT US FOR MORE INFORMATION
Pfizer Oncology Together or a local Pfizer Oncology Account Specialist can provide more information on this co-pay savings program. Give us a call at 1-877-744-5675 (Monday–Friday 8 AM–8 PM ET).
#For patients to be eligible for the Injectables Co-Pay Program for RUXIENCE, they must have commercial insurance that covers RUXIENCE™ (rituximab-pvvr) and they cannot be enrolled in a state or federally funded insurance program. Whether a co-pay expense is eligible for the Injectables Co-Pay Program for RUXIENCE benefit will be determined at the time the benefit is paid. Co-pay expenses must be in connection with a separately paid claim for RUXIENCE administered in the outpatient setting.
**The Injectables Co-Pay Program for RUXIENCE will pay the co-pays for RUXIENCE up to the annual assistance limit of $25,000 per calendar year per patient.
††The Injectables Co-Pay Program for RUXIENCE provides assistance for eligible, commercially insured patients for co-pays or coinsurance incurred for RUXIENCE, up to $25,000 per calendar year. It does not cover or provide support for supplies, services, procedures, or any other physician-related services associated with RUXIENCE treatment.
Pfizer Oncology Together Co-Pay Savings Program for Injectables: TRAZIMERA™ (trastuzumab-qyyp)
The Pfizer Oncology Together Co-Pay Savings Program for Injectables provides eligible, commercially insured patients prescribed TRAZIMERA with support for out-of-pocket drug costs, including co-pays and coinsurance. Limits, terms, and conditions apply.
ELIGIBLE, COMMERCIALLY INSURED PATIENTS# MAY PAY AS LITTLE AS $0 FOR EACH TRAZIMERA TREATMENT**
- This program covers up to $25,000 per calendar year††
- There are no income requirements for patients to qualify
HELP YOUR PATIENTS ENROLL
To get started, fax a completed enrollment form to 1-877-736-6506, or fill out an enrollment form online through our provider portal. Be sure to fill out the section requesting enrollment in the Injectables Co-Pay Program and indicate if the patient will assign benefits to the healthcare provider.
OTHER RESOURCES
For information on enrollment, claims submission, and reimbursement, download the TRAZIMERA co-pay savings program brochure below.
To submit claims, complete the claim form
below and send via fax or mail:
Fax: 1-855-630-9962
Mail: P.O. Box 10691, Fairfield, NJ 07004
To find additional co-pay program documents and information on the claims submission process, go to the Forms & Resources page.
Please see full Prescribing Information for TRAZIMERA, including BOXED WARNING, or visit TRAZIMERAhcp.com.
CONTACT US FOR MORE INFORMATION
Pfizer Oncology Together or a local Pfizer Oncology Account Specialist can provide more information on this co-pay savings program. Give us a call at 1-877-744-5675 (Monday–Friday 8 AM–8 PM ET).
#For patients to be eligible for the Injectables Co-Pay Program for TRAZIMERA, they must have commercial insurance that covers TRAZIMERA™ (trastuzumab-qyyp) and they cannot be enrolled in a state or federally funded insurance program. Whether a co-pay expense is eligible for the Injectables Co-Pay Program for TRAZIMERA benefit will be determined at the time the benefit is paid. Co-pay expenses must be in connection with a separately paid claim for TRAZIMERA administered in the outpatient setting.
**The Injectables Co-Pay Program for TRAZIMERA will pay the co-pays for TRAZIMERA up to the annual assistance limit of $25,000 per calendar year per patient.
††The Injectables Co-Pay Program for TRAZIMERA provides assistance for eligible, commercially insured patients for co-pays or coinsurance incurred for TRAZIMERA, up to $25,000 per calendar year. It does not cover or provide support for supplies, services, procedures, or any other physician-related services associated with TRAZIMERA treatment.
Pfizer Oncology Together Co-Pay Savings Program for Injectables for ZIRABEV
The Pfizer Oncology Together Co-Pay Savings Program for Injectables for ZIRABEV provides eligible patients with support for out-of-pocket drug costs, including co-pays and coinsurance. Limits, terms, and conditions apply.
HELP YOUR PATIENTS ENROLL
To get started, fax a completed enrollment form to 1-877-736-6506. Be sure to check the box for Injectables Co-Pay Program and indicate if the patient will assign benefits to the healthcare provider.
For eligible, commercially insured patients#
Eligible patients may pay as little as $0 for each ZIRABEV treatment. **
UP TO $25,000 PER CALENDAR YEAR
The program covers up to $25,000 per calendar year. ††
No income requirements
There are no income requirements for you to qualify.
OTHER RESOURCES
For information on enrollment, claims submission, and reimbursement, download the Pfizer Oncology Together Co-Pay Savings Program for Injectables for ZIRABEV brochure.
To submit claims, complete the Pfizer Oncology Together Co-Pay Savings Program for Injectables for ZIRABEV
Claim Form and send via fax or mail:
Fax: 1-973-843-1916
Mail: P.O. Box 10514, Fairfield, NJ 07004
For Sample forms and additional co-pay program documents, go to the Forms & Resources page.
CONTACT US FOR MORE INFORMATION
Pfizer Oncology Together or a local Pfizer Oncology Account Specialist can provide more information on this co-pay savings program. Give us a call at 1-877-744-5675 (Monday–Friday 8 AM–8 PM ET).
#For patients to be eligible for the Injectables Co-Pay Program, they must have commercial insurance that covers ZIRABEV™ (bevacizumab-bvzr) (referred to as “Product”) and they cannot be enrolled in a state or federally funded insurance program. Whether a co-pay expense is eligible for the Injectables Co-Pay Program benefit will be determined at the time the benefit is paid. Co-pay expenses must be in connection with a separately paid claim for Product administered in the outpatient setting.
**The Injectables Co-Pay Program will pay the co-pay and any deductible obligations for the Product up to the annual assistance limit of $25,000 per calendar year per patient.
††The Injectables Co-Pay Program provides assistance for eligible, commercially insured patients for co-pays, coinsurance, or deductibles incurred for the Product, up to $25,000 per calendar year. It does not cover or provide support for supplies, services, procedures, or any other physician-related services associated with Product treatment.
Pfizer Oncology Together Co-Pay Savings Program for Injectables: NIVESTYM® (filgrastim-aafi)
The Pfizer Oncology Together Co-Pay Savings Program for Injectables provides eligible, commercially insured patients prescribed NIVESTYM with support for out-of-pocket drug costs, including co-pays and coinsurance. Limits, terms, and conditions apply.
ELIGIBLE, COMMERCIALLY INSURED PATIENTS# MAY PAY AS LITTLE AS $0 FOR EACH NIVESTYM TREATMENT**
- This program covers up to $10,000 per calendar year††
- There are no income requirements for patients to qualify
HELP YOUR PATIENTS ENROLL
To get started, fax a completed enrollment form to 1-877-736-6506, or fill out an enrollment form online through our provider portal. Be sure to fill out the section requesting enrollment in the Injectables Co-Pay Program and indicate if the patient will assign benefits to the healthcare provider.
OTHER RESOURCES
For information on enrollment, claims submission, and reimbursement, download the NIVESTYM co-pay savings program brochure below.
To submit claims, complete the claim form
below and send via fax or mail:
Fax: 1-833-307-2193
Mail: P.O. Box 10751, Fairfield, NJ 07004
To find additional co-pay program documents and information on the claims submission process, go to the Forms & Resources page.
CONTACT US FOR MORE INFORMATION
Pfizer Oncology Together or a local Pfizer Oncology Account Specialist can provide more information on this co-pay savings program. Give us a call at 1-877-744-5675 (Monday–Friday 8 AM–8 PM ET).
#For patients to be eligible for the Injectables Co-Pay Program for NIVESTYM, they must have commercial insurance that covers NIVESTYM® (filgrastim-aafi) and they cannot be enrolled in a state or federally funded insurance program. Whether a co-pay expense is eligible for the Injectables Co-Pay Program for NIVESTYM benefit will be determined at the time the benefit is paid. Co-pay expenses must be in connection with a separately paid claim for NIVESTYM administered in the outpatient setting.
**The Injectables Co-Pay Program for NIVESTYM will pay the co-pays for NIVESTYM up to the annual assistance limit of $10,000 per calendar year per patient.
††The Injectables Co-Pay Program for NIVESTYM provides assistance for eligible, commercially insured patients for co-pays or coinsurance incurred for NIVESTYM, up to $10,000 per calendar year. It does not cover or provide support for supplies, services, procedures, or any other physician-related services associated with NIVESTYM treatment.
Braftovi-Mektovi HCP Copay Form
*Required field.
Your patient may not be eligible for co-pay assistance if their medication is not listed above. For additional financial assistance questions, call us at 1-877-744-5675.
ADDITIONAL ASSISTANCE
Free medication may be available to eligible patients through the Pfizer Patient Assistance Program.†
Contact Pfizer Oncology Together for more information.
Please see full Prescribing Information for DAURISMO (glasdegib), including BOXED WARNING and Medication Guide, or visit DAURISMOhcp.com.
Please see full Prescribing Information for RETACRIT (epoetin alfa-epbx), including BOXED WARNING and Medication Guide, or visit RETACRIThcp.com.
Please see full Prescribing Information for RUXIENCE (rituximab-pvvr), including BOXED WARNING and Medication Guide, or visit RUXIENCEhcp.com.
Please see full Prescribing Information for SUTENT (sunitinib malate), including BOXED WARNING and Medication Guide, or visit SUTENThcp.com.
Please see full Prescribing Information for TRAZIMERA (trastuzumab-qyyp), including BOXED WARNING, or visit TRAZIMERAhcp.com.
†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.
Medicare/Government Insured
We can help identify resources for patients with Medicare/Medicare Part D, Medicaid, and other government insurance plans.
Support from independent charitable foundations
We’ll 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.
MEDICARE EXTRA HELP
We’ll check patient eligibility for Medicare Part D Low-Income Subsidy (Extra Help). If patients appear to be eligible, we can help them understand how to apply.
Free Medication
If support from independent charitable foundations or Medicare Extra Help is not available, we’ll provide eligible patients with medication for free through the Pfizer Patient Assistance Program.‡ Patients may receive their medication at no cost for the remainder of the calendar year. Patients must reapply annually.
Uninsured
We can help identify resources for patients who do not have any form of healthcare coverage.
Help finding coverage
We’ll check patient eligibility for Medicaid. If patients appear to be eligible, we can help them understand how to apply.
Free MEDICATION Or savings
Eligible patients may receive up to a 90-day supply of Pfizer medications for free while applying for Medicaid.§ If patients do not qualify for Medicaid, they may be able to get a 1-year supply of their medication for free through the Pfizer Patient Assistance Program,|| or at a savings through the Pfizer Savings Program.¶ Patients must meet the eligibility requirements and reapply as needed.
Free Trial Vouchers
Patients who have been newly prescribed certain Pfizer Oncology medications may be able to start therapy with a free trial voucher. To learn more about which medications offer vouchers, speak to your Pfizer Oncology Account Specialist or go to the Products page and select the product you’re interested in.
