ELREXFIO

Indicated For

Relapsed or refractory multiple myeloma

About This Medication

# Pfizer Oncology Together Patient Guide: How to Get ELREXFIO (elranatamab-bcmm) at Low or No Cost ELREXFIO (elranatamab-bcmm) is a prescription injectable medication used to treat certain types of multiple myeloma in adults who have received at least four prior lines of therapy. Pfizer Oncology Together offers **co-pay assistance** for commercially insured patients and **free medication** through the Pfizer Patient Assistance Program (PAP) for uninsured or government-insured patients who meet strict eligibility criteria, including income limits at or below **300% of the Federal Poverty Level (FPL)**.[1][2][6] ## About ELREXFIO and Why Assistance Matters ELREXFIO is a bispecific B-cell maturation antigen (BCMA)-directed CD3 T-cell engager administered by subcutaneous injection, typically in a healthcare setting. It works by helping your immune system target and kill cancer cells in relapsed or refractory multiple myeloma. Treatment often involves step-up dosing to manage side effects like cytokine release syndrome. Without assistance, costs can be prohibitive—thousands per dose—making programs like Pfizer Oncology Together essential for access.[5] This guide explains eligibility, application steps, and support options in plain language. Always consult your doctor for personalized advice. ## Who Qualifies for Assistance? Pfizer Oncology Together has **two main tracks**: 1. **Co-Pay Savings Program (for Commercially Insured Patients)**: Reduces out-of-pocket costs (up to $10,000–$25,000 per year). You must have **commercial insurance** (e.g., employer or marketplace plans)—**not government insurance like Medicare, Medicaid, or TRICARE**.[2][4][5] 2. **Pfizer Patient Assistance Program (PAP) for Free Medication**: Provides ELREXFIO at **no cost** if you are: - Uninsured, or - Insured through government programs (Medicare, Medicaid, etc.) and unable to afford costs, or - Denied coverage by your insurer after appeal.[1][2][6] **All patients must**: - Reside in the U.S. or U.S. territory. - Have a valid U.S. prescription for an FDA-approved use. - Be 18+ years old. - Meet income requirements (detailed below).[1][6][8] **Medicare Part D/Advantage patients**: Must enroll in the Medicare Prescription Payment Plan, not have met your annual out-of-pocket maximum, and attest to inability to afford costs.[1] ## Income Eligibility Breakdown PAP eligibility requires household income ≤ **300% FPL**, adjusted for household size. No strict thresholds listed for co-pay (income not primary factor, but program discretion applies). Use this table for 2026 FPL estimates (check HHS.gov for exact figures, as they update yearly).[1][6] | Household Size | 100% FPL | 300% FPL Maximum | |---------------|----------|------------------| | 1 | $15,060 | $45,180 | | 2 | $20,440 | $61,320 | | 3 | $25,820 | $77,460 | | 4 | $31,200 | $93,600 | | 5 | $36,580 | $109,740 | | Add per person| +$5,380 | +$16,140 | *Proof required: Electronic verification, prior year tax return (Page 1 of 1040), W-2s, or 3 recent pay stubs for all household members.*[1][6] ## Insurance Requirements - **Commercial Insurance**: Eligible for co-pay card (not valid if prohibited by your plan). Covers copays, deductibles, coinsurance.[4][5] - **Government Insurance (Medicare, Medicaid, etc.)**: **Ineligible for co-pay**; apply for PAP free medicine if income-qualified and unaffordable.[1][2][3] - **Uninsured**: PAP eligible if income ≤300% FPL. - **Denied Coverage**: Appeal first, then PAP if denied.[6][8] Work with your doctor's office/pharmacy/insurer to understand costs **after prior authorization (PA)**, if required.[1][3] ## Step-by-Step Application Process **Multiple methods**—choose what's easiest. Call **(877) 744-5671** (Mon–Fri 8am–8pm ET) for help. 1. **Check Eligibility**: Discuss with your doctor. Get PA approved if needed. Verify insurance costs.[1][3] 2. **Gather Documents**: - Prescription for ELREXFIO. - Proof of income (see above). - Insurance info or denial letter. - For Medicare: Enrollment Payment Plan proof.[1][6] 3. **Enroll**: - **Online**: PfizerOncologySignUp.com/injectable—select ELREXFIO.[3] - **Phone**: (877) 744-5671. - **Fax**: Doctor faxes form to 1-877-736-6506.[3] - Doctor/HCP submits enrollment form.[8] 4. **Submit Claims** (Co-Pay): Within 180 days of treatment; include Explanation of Benefits (EOB).[5] 5. **Approval Notice**: Mailed with co-pay card or PAP confirmation.[5] **Reauthorization**: Required (reauth every 12 months or as needed; reapply annually for PAP).[6] ## Timeline and Delivery - **Processing**: Varies; Pfizer follows up on missing info. Expect 2–4 weeks typically (call for status).[5] - **Delivery**: **Outpatient administration**—sent to your doctor's office/infusion center/pharmacy, not home. - **Refills**: HCP resubmits claims; PAP requires annual reapplication.[5][6] ## Alternatives if Denied - **Appeal Denial**: Contact insurer/Pfizer for PA help.[3] - **Other Resources**: Pfizer RxPathways (up to 500% FPL in some cases), Patient Access Network (PAN) Foundation, or state programs.[7][8] - **Switch Programs**: Try co-pay if commercial; PAP if government/uninsured. - **Financial Counseling**: Call Pfizer at (877) 744-5671 for options.[6] ## Important Disclaimer This guide is for informational purposes only and based on publicly available data as of 2026. Eligibility, terms, and FPL can change—verify at PfizerOncologyTogether.com or by calling (877) 744-5671. Pfizer may amend/revoke programs without notice. Not health insurance. Consult your healthcare provider; do not delay treatment. This is not medical/financial advice.

Program information last verified: March 30, 2026