VIZIMPRO

Indicated For

metastatic non-small cell lung cancer (NSCLC) with EGFR exon 19 deletion or exon 21 L858R substitution mutations

About This Medication

# Pfizer Patient Assistance Program Guide: How to Get VIZIMPRO at Low or No Cost ## About This Guide If you've been prescribed VIZIMPRO (dacomitinib) to treat metastatic non-small cell lung cancer (NSCLC), you may be concerned about the cost of your medication. This guide explains how the Pfizer Patient Assistance Program can help you access VIZIMPRO at reduced or no cost, depending on your financial situation and insurance status. ## What Is VIZIMPRO? VIZIMPRO is a prescription medication used to treat advanced lung cancer in patients whose cancer has specific genetic mutations (EGFR exon 19 deletion or exon 21 L858R substitution). VIZIMPRO belongs to a class of drugs called kinase inhibitors, which work by blocking proteins that help cancer cells grow. This medication is typically taken once daily as an oral tablet. ## About the Pfizer Patient Assistance Program The Pfizer Patient Assistance Program is a free program designed to help patients who cannot afford their medications. Pfizer offers VIZIMPRO at reduced costs or free of charge to eligible patients. The program serves people with various insurance situations: - Uninsured patients - Underinsured patients (those with high out-of-pocket costs) - Medicare patients - Medicaid patients - Patients with other government insurance programs **Important Note:** If you have commercial insurance, you may not be eligible for free medication through this program, but other financial assistance options may be available to you. ## Who Can Apply? ### Income Eligibility To qualify for VIZIMPRO assistance, your household income must not exceed 400% of the Federal Poverty Level (FPL). The chart below shows the maximum annual household income limits based on your household size: | Household Size | Maximum Annual Income | |---|---| | 1 person | $75,000 | | 2 people | $101,250 | | 3 people | $127,500 | | 4 people | $153,750 | | 5 people | $180,000 | | 6 people | $206,250 | | 7 people | $232,500 | | 8 people | $258,750 | | Each additional person | Add $26,250 | **Note:** These limits are based on 400% of FPL. Your actual eligibility may vary depending on your specific circumstances. Even if your income exceeds these guidelines, contact the program to discuss your situation—you may still qualify. ### Insurance Requirements The program serves patients with the following insurance statuses: - **Uninsured:** You have no health insurance coverage - **Underinsured:** You have insurance but face high copayments, coinsurance, or deductibles - **Medicare:** You are covered by Medicare (Part A, B, C, or D) - **Medicaid:** You receive Medicaid benefits - **Other Government Programs:** You're covered by TRICARE, VA, or similar programs - **Commercial Insurance:** Generally not eligible for free medication, but you may qualify for a savings card (see below) ### Documents You'll Need When applying, have the following documents ready: 1. **Valid Prescription** — Your doctor's signed prescription for VIZIMPRO 2. **Proof of Income** — Recent tax returns, pay stubs, Social Security statements, or benefit letters 3. **Proof of Residency** — Utility bills, lease, or mortgage statement (must be from the past 60 days) 4. **Proof of Insurance Status** — Insurance card, denial letter, or statement showing your insurance situation ## How to Apply The Pfizer Patient Assistance Program accepts applications through multiple methods: ### Method 1: Online Application Visit **https://www.pfizeroncologytogether.com/patient/financial-assistance** to complete an online application. You'll be guided through each step and can upload required documents. ### Method 2: Phone Application Call **1-800-350-3080** to speak with a program representative who can help you apply over the phone. They can answer questions and guide you through the process. ### Step-by-Step Application Instructions **Step 1: Gather Your Documents** - Collect the four required document types listed above - Make copies or have digital versions ready **Step 2: Choose Your Application Method** - Decide whether you prefer applying online or by phone - Have your documents accessible before starting **Step 3: Complete the Application** - **Online:** Fill out the form at the website above, carefully entering all household members and income information - **Phone:** Call 1-800-350-3080 and provide the same information to a representative - Be honest about your income and insurance status; this helps ensure you receive appropriate assistance **Step 4: Submit Documentation** - **Online:** Upload images or PDFs of your required documents through the website - **Phone:** The representative will inform you how to send documents (often by mail or fax) **Step 5: Wait for Approval** - The program typically reviews applications within 4-8 weeks - You'll be contacted by mail, phone, or email with a decision - Once approved, you'll receive information about how to receive your medication **Step 6: Receive Your Medication** - VIZIMPRO will be shipped directly to you or to your doctor's office - Follow the delivery instructions provided - Your doctor will provide ongoing prescriptions as needed ## Timeline and What to Expect **Application Processing:** 4-8 weeks is typical. However, processing times may vary depending on the completeness of your application and the volume of requests. **Medication Delivery:** Once approved, medications are typically shipped within 2-3 weeks. **Reauthorization:** Your assistance is usually approved for one year. You'll need to reapply annually to continue receiving support. The program will remind you when reauthorization is needed. ## If You Have Commercial Insurance If you have commercial (private) insurance, you may not qualify for free medication through the Pfizer Patient Assistance Program. However, Pfizer offers a **savings card** that can help reduce your out-of-pocket costs. Visit the program website at **https://www.pfizeroncologytogether.com/patient/financial-assistance** to learn about the savings card and other cost-reduction options. ## What Happens If Your Application Is Denied? If your application is denied, don't lose hope. Possible reasons include: - Income exceeds program limits - Missing or incomplete documentation - Insurance does not meet program criteria **Next Steps:** - Contact the program at 1-800-350-3080 to understand the reason for denial - Ask if you can provide additional information or appeal the decision - Explore alternative assistance programs (see below) - Discuss cost-reduction options with your doctor or hospital financial counselor ## Other Financial Assistance Options If you don't qualify for the Pfizer Patient Assistance Program, consider: 1. **Hospital Financial Counselors** — Ask your treatment center if they have financial counselors who can help with medication costs 2. **Pharmaceutical Savings Cards** — Third-party programs may offer discounts on VIZIMPRO 3. **State Pharmaceutical Assistance Programs** — Many states offer medication assistance for low-income residents 4. **Nonprofit Organizations** — Groups like CancerCare, Patient Advocate Foundation, and American Cancer Society may offer financial grants 5. **Disease-Specific Programs** — Lung cancer organizations may have special assistance programs ## Important Reminders - **Be Honest:** Provide accurate information about income and insurance status - **Don't Wait:** Apply as soon as you're prescribed VIZIMPRO; don't delay starting treatment - **Keep Records:** Save copies of all documents you submit and confirmation numbers from your application - **Stay in Touch:** Respond promptly to any requests for additional information from the program - **Plan Ahead:** Apply for reauthorization before your current assistance expires ## Contact Information **Pfizer Oncology Together Program** - **Phone:** 1-800-350-3080 - **Website:** https://www.pfizeroncologytogether.com/patient/financial-assistance - **Hours:** Generally Monday-Friday, 9 AM-5 PM ET (call to confirm) ## Legal Disclaimer This guide is intended to provide general information about the Pfizer Patient Assistance Program for VIZIMPRO. The information is current as of the publication date but may change. For the most accurate and up-to-date information regarding eligibility, requirements, and application procedures, please contact the program directly or visit the official website. This guide does not constitute medical advice, and patients should consult with their healthcare provider regarding their treatment options. Pfizer reserves the right to modify or discontinue this program at any time. Patients should verify that they meet all current program requirements before applying.

Program information last verified: March 25, 2026