We are dedicated to helping you access and afford your medicine
banner image mobile:
If you have commercial insurance, you may be eligible for the Pfizer Oncology Together Co-Pay Program for IV ("IV Co-Pay Program"). Limits, terms, and conditions apply. See below for full Terms and Conditions.
Eligible Commercially Insured Patients* Co-pay may be as little as $0. Once the annual program limit is reached, the patient is responsible for the full co-pay.†
$25,000 per Calendar Year Program covers up to $25,000‡ per calendar year
No Income Requirements There are no income requirements to qualify
*For patients to be eligible for the IV Co-Pay Program, they must have commercial insurance that covers BESPONSA, 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 BESPONSA administered in the outpatient setting.
†The IV Co-Pay Program will pay the co-pay and any deductible obligations for BESPONSA up to the annual assistance limit of $25,000 per calendar year per patient.
‡IV Co-Pay Program provides assistance for eligible, commercially insured patients for co-pays, co-insurance, or deductibles incurred for BESPONSA, 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 BESPONSA treatment.
By enrolling in the Pfizer Oncology Together Co-Pay Program for IV (“IV Co-Pay Program”), you acknowledge that you currently meet the eligibility criteria and will comply with the Terms and Conditions described below:
For more information about the Pfizer Oncology Together Co-Pay Program for IV, call 1-877-744-5675 or write Pfizer Oncology Together Co-Pay Program for IV, P.O. Box 220366, Charlotte, NC 28222-0366.
BACK TO TOP
We’ll help you search 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.
If independent charitable foundation support is not available, we will provide eligible patients with BESPONSA 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.
BACK TO TOP
We can check to see if you’re eligible for a government program that helps pay for prescription medicines through Medicaid or Medicare Part D. If you are eligible, we can guide you on how to apply, and we’ll provide assistance throughout the process
If you do not have insurance or prescription coverage and you are unable to afford your medication, we may be able to help. Pfizer Oncology Together can provide you with BESPONSA 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.
REMEMBER, COMPLETE ALL ENROLLMENT FORMS WITH YOUR HEALTHCARE TEAM
BACK TO TOP