Rapamune

Indicated For

organ transplant rejection prophylaxis

About This Medication

# Pfizer Patient Assistance Program Patient Guide: How to Get Rapamune (Sirolimus) at Low or No Cost ## About This Program The **Pfizer Patient Assistance Program** provides **Rapamune (sirolimus) for free** to eligible patients who cannot afford their medication. This program is a joint effort between Pfizer Inc. and the Pfizer Patient Assistance Foundation, and has helped over 44,000 patients receive more than 351,000 Pfizer prescriptions for free in 2024.[5] ## Who Qualifies for Rapamune Assistance? To be eligible for free Rapamune through the Pfizer Patient Assistance Program, you must meet ALL of the following requirements: **Basic Requirements:** - Have a **valid prescription** for Rapamune written by a healthcare provider licensed in the US[2] - Be treated in an **outpatient setting** (not hospitalized)[2] - Live in the **United States, Puerto Rico, or US Virgin Islands**[2] - Be **unable to afford** your medication, even with insurance assistance[7] **Insurance Requirements:** You must be **uninsured or publicly insured**. This means you qualify if you have: - No prescription drug coverage (uninsured) - Medicare - Medicaid - CHAMPUS/TRICARE - VA coverage **Important:** If you have **commercial insurance** (insurance through your job or a Federal Employer Plan), you are **not eligible** for this program, even if you cannot afford your copayment.[2] **Income Requirements:** While Pfizer does not publicly disclose specific income thresholds, the program is designed for patients with financial need. You will need to provide proof of your income during the application process.[2] ## About Rapamune (Sirolimus) Rapamune is an immunosuppressant medication commonly prescribed to prevent organ rejection in transplant recipients. The Pfizer Patient Assistance Program helps ensure that cost is not a barrier to accessing this important medication. ## Insurance Eligibility at a Glance | Insurance Type | Eligible? | Notes | |---|---|---| | Uninsured | Yes | Must demonstrate financial need | | Medicare | Yes | Must meet income/financial criteria | | Medicaid | Yes | Must meet income/financial criteria | | CHAMPUS/TRICARE | Yes | Military health coverage | | VA Coverage | Yes | Veterans Administration | | Commercial Insurance | No | Not eligible regardless of copayment amount | ## Step-by-Step Application Process ### Step 1: Gather Required Documents Before you begin, collect the following: - **Completed enrollment form** (available at www.PfizerRxPathways.com) - **Valid prescription** for Rapamune from your healthcare provider - **Proof of income** (choose ONE of the following):[2][4] - Pages 1 & 2 of your previous year's federal tax return (Form 1040 or 1040EZ) - W-2 forms from your employer - Two recent paycheck stubs - Social Security, pension, or railroad retirement statements (SSA-1099 or similar) ### Step 2: Complete Your Application You have two options for applying: **Option A: Online Application (Recommended)** If Rapamune is available through Pfizer PAP Connect: 1. Visit www.PfizerRxPathways.com 2. Use the Program Finder tool 3. Enter "Rapamune" and follow the onscreen instructions 4. Complete your application online through Pfizer PAP Connect[1] 5. Upload your proof of income documents 6. Track your application progress online[9] **Option B: Paper Application** If you cannot apply online: 1. Download the enrollment form from www.PfizerRxPathways.com 2. Complete and sign the patient section 3. Have your prescriber complete and sign their section 4. Gather your proof of income documents ### Step 3: Submit Your Application **By Mail:** Pfizer Patient Assistance Program P.O. Box 66585 St. Louis, MO 63166-6585 **By Fax:** 866-470-1748 (Include a cover page from your prescriber's office) **Important:** Do not send medical records or other documentation beyond what is requested.[4] ### Step 4: Wait for Approval You will receive notification of your enrollment status within **2 to 3 weeks** of submitting your application.[1][2] If approved, you will receive a letter with your enrollment term and instructions on how you will receive your Rapamune. ## Timeline and Medication Delivery - **Application Processing:** 2-3 weeks from submission - **Delivery Method:** Rapamune can be shipped directly to your home or to your physician's office, depending on what works best for you[2] - **Reauthorization:** Your enrollment will need to be renewed periodically. Pfizer will notify you when reauthorization is required ## What If Your Application Is Denied? If you are not approved for the Pfizer Patient Assistance Program, consider these alternatives: - **Contact Pfizer directly** at 1-844-989-PATH (7284) to speak with a Medicine Access Counselor who can explain the reason and discuss other options[2] - **Explore other patient assistance programs** through organizations like NeedyMeds or Patient Advocate Foundation - **Ask your healthcare provider** about other financial assistance options or generic alternatives - **Reapply** if your financial situation changes ## Important Information **Reauthorization:** Your enrollment in the Pfizer Patient Assistance Program is not permanent. You will need to reauthorize your enrollment periodically to continue receiving free Rapamune. Pfizer will contact you with instructions when reauthorization is needed. **Eligibility Changes:** If your insurance status changes (for example, if you become commercially insured), you will no longer be eligible for the program. **Privacy:** Your personal and financial information is protected and used only to determine eligibility and process your application. ## Contact Information **For Questions About Eligibility or the Application:** Call 1-844-989-PATH (7284) to speak with a Pfizer Medicine Access Counselor **To Apply Online:** Visit www.PfizerRxPathways.com ## Disclaimer This guide provides general information about the Pfizer Patient Assistance Program as of March 2026. Program eligibility requirements, application procedures, and covered medications may change at any time. For the most current and complete information, visit www.PfizerRxPathways.com or call 1-844-989-PATH (7284). This guide is not a guarantee of eligibility or approval. Each application is reviewed individually based on current program criteria.

Program information last verified: March 30, 2026