Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Program 1 of 3.
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Pfizer Oncology Together

This program provides brand name medications at no or low cost

Provided by: Pfizer, Inc.

PO Box 220366
Charlotte, NC 28222-0366

TEL: 877-744-5675


FAX: 877-736-6506
Languages Spoken:

English, Spanish

Program Website

 

Program Applications and Forms

Pfizer Oncology Together Enrollment Form

Pfizer Oncology Together Enrollment Form (Spanish)

 

Medications

  • axitinib tablet (Inlyta) Tablet
 

Eligibility Requirements   

Insurance Status Contact program for details.
Those with Part D Eligible? Contact program for details.
Income Not disclosed
Diagnosis/Medical Criteria Varies
US Residency Required? Must be treated by US Doctor
   

Application

Obtaining Call or download
Receiving Faxed or downloaded from website
Returning Fax, mail or via Online Portal
Doctor's Action Varies
Applicant's Action Complete section, sign, attach required documents
Decision Communicated Not specified
Decision Timeframe Varies
   

Medication

Amount/Supply Varies
Sent To Varies
Delivery Time Varies
Refill Process Not specified
Limit Varies
Re-application Not specified
   

Additional Information

Co-payment assistance, reimbursement support, and patient assistance programs are available for eligible patients.

Updated September 14, 2020


Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Program 2 of 3.
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Pfizer Savings Program

This program provides brand name medications at no or low cost

Provided by: Pfizer, Inc.


TEL: 866-706-2400


ALT PHONE: 855-239-9869
Languages Spoken:

English, Spanish

Program Website

 

Program Applications and Forms

Pfizer Savings Program Medication List

Pfizer Institutional Patient Assistance Program (IPAP) At-a-Glance Brochure

 

Medications

  • axitinib tablet (Inlyta) Tablet
 

Eligibility Requirements   

Insurance Status Must be uninsured
Those with Part D Eligible? No
Income Varies
Diagnosis/Medical Criteria Not specified
US Residency Required? Must be residing in the US or US territory
   

Application

Obtaining Call for prescreening
Receiving There is no application
Returning Not applicable
Doctor's Action Give prescription to patient
Applicant's Action Call to enroll
Decision Communicated Decision made during phone screening
Decision Timeframe Decision made during phone screening
   

Medication

Amount/Supply Contact the program for more details.
Sent To Pharmacy
Delivery Time Not applicable
Refill Process Varies per medication
Limit None
Re-application New enrollment every 12 months
   

Additional Information

This program provides uninsured patients with savings on their prescriptions at the pharmacy.

Pfizer also has programs that provide eligible patients with insurance support, copay assistance, and medicines for free. Contact Pfizer RxPathways for details (844-989-7284)

Updated July 08, 2020


Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Program 3 of 3.
 

Patient Access Network Foundation (PAN)

This is a copay assistance program

Provided by: Patient Access Network Foundation


TEL: 866-316-7263


FAX: 866-316-7261
Languages Spoken:

English, Spanish, Others By Translation Service

Program Website

 

Program Applications and Forms

Patient Access Network Foundation (PAN) Application: Contact program

 

Medications

  • axitinib tablet (Inlyta) Tablet
 

Eligibility Requirements   

Insurance Status *See Additional Information section below
Those with Part D Eligible? Determined case by case
Income Between 400-500% of FPL
Diagnosis/Medical Criteria FDA Approved Diagnosis - See Program Website for Details
US Residency Required? Must reside and receive treatment in US
   

Application

Obtaining Call or complete online
Receiving Complete online or by phone
Returning Complete online or by phone
Doctor's Action Will be discussed with patient and Doctor after request is received
Applicant's Action Call for information or inform doctor that he/she is in need
Decision Communicated Patient and Doctor notified in writing
Decision Timeframe Within 48 hours
   

Medication

Amount/Supply Not applicable
Sent To Patient sent card to be used at pharmacy
Delivery Time Once approved; shipped same day
Refill Process Patient presents voucher/card to pharmacy for each refill
Limit None
Re-application New application every 12 months
   

Additional Information

*Patients must have health insurance and their insurance must cover the qualifying medication for which they seek assistance.

Call for most recent medications as the list is subject to change and the medication for which you are seeking assistance must treat the disease directly.

Note: All new enrollment is now done electronically or over the phone. Contact program for details.

Updated September 01, 2020