XALKORI

Indicated For

ALK-positive metastatic NSCLC, relapsed/refractory systemic ALK-positive anaplastic large cell lymphoma

About This Medication

# Pfizer Patient Assistance Program Patient Guide: How to Get XALKORI (crizotinib) at Low or No Cost XALKORI (crizotinib) is a targeted oral therapy used to treat certain types of advanced lung cancer and other cancers with specific genetic changes, such as ROS1-positive or ALK-positive non-small cell lung cancer (NSCLC). The **Pfizer Patient Assistance Program (PAP)** offers **XALKORI at no cost** to eligible uninsured or underinsured patients facing financial hardship, helping bridge the gap when insurance coverage falls short.[1][3] ## About XALKORI (crizotinib) **XALKORI** is a prescription kinase inhibitor that blocks proteins involved in cancer cell growth. It's approved for adults with metastatic NSCLC whose tumors have ALK or ROS1 gene fusions, and in some pediatric cases for anaplastic large cell lymphoma (ALCL). Treatment typically involves daily capsules, but costs can exceed $15,000 per month without assistance, making programs like Pfizer PAP vital for access.[1][3] Always take XALKORI as prescribed by your doctor. Common side effects include vision changes, nausea, diarrhea, and liver issues—report any severe symptoms immediately. This guide focuses on financial help, not medical advice; consult your healthcare provider for treatment details.[1] ## Who Qualifies for the Pfizer Patient Assistance Program? To qualify, you must: - Be 18+ years old and live in the U.S., Puerto Rico, or U.S. Virgin Islands. - Have a valid prescription from a U.S.-licensed healthcare provider (HCP) for outpatient use. - Lack sufficient insurance coverage (uninsured, underinsured, or denied by insurer after appeal). - Meet income limits, generally at or below **500% of the Federal Poverty Level (FPL)**.[1][2][4] **Commercially insured patients do not qualify** for this PAP but may access a separate Pfizer co-pay program for savings as low as $0/month.[3][4][6] ## Income Eligibility Breakdown Eligibility hinges on household income relative to FPL, which adjusts annually (e.g., 2026 figures based on U.S. Department of Health guidelines). Pfizer PAP typically covers up to **500% FPL**, though program data notes 400-500% range—confirm current limits via phone.[1][2] | Household Size | 100% FPL (approx.) | 400% FPL (approx.) | 500% FPL (approx.) | |----------------|---------------------|---------------------|---------------------| | 1 (Individual) | $15,060 | $60,240 | $75,300 | | 2 (Couple) | $20,440 | $81,760 | $102,200 | | 3 | $25,820 | $103,280 | $129,100 | | 4 | $31,200 | $124,800 | $156,000 | *Notes: Add ~$5,380 per additional person for FPL. Figures are estimates; use Pfizer's tool at PfizerRxPathways.com for exacts. Proof like tax returns or pay stubs required.[1][2][4][10]* ## Insurance Requirements - **Uninsured**: Fully eligible if income-qualified. - **Government insurance** (Medicare, Medicaid, etc.): Eligible if expressing financial need; Pfizer helps identify foundations or Extra Help (Low-Income Subsidy).[3][6] - **Commercial/Private insurance**: **Not eligible**—exhausted co-pay options first via Pfizer Oncology Together.[1][4][5] - Denied coverage? Submit appeal proof.[1] ## Step-by-Step Application Process 1. **Check eligibility**: Call (877) 744-5675 (Mon-Fri, 8am-8pm ET) or visit PfizerRxPathways.com Program Finder. Enter "XALKORI".[2][4] 2. **Gather documents**: - Proof of residency (e.g., utility bill). - Proof of income (2025 tax return pages 1-2, W-2, 2 pay stubs, SSA-1099). - Insurance status (front/back of cards or denial letter). - Valid XALKORI prescription.[1][4][10] 3. **Complete form**: Download from https://www.xalkori.com/files/Enrollment_Form.pdf. Patient/caregiver fills pages 2-3; HCP signs.[1] 4. **Submit**: - **Online**: Pfizer PAP Connect (pfizerrxpathways.com/pfizer-pap-connect)—upload docs, track status.[2][7] - **Phone**: (877) 744-5675 for guidance. - **Mail/Fax**: Per form instructions (e.g., P.O. Box 66585, St. Louis, MO 63166-6585; Fax: 866-470-1748).[10] 5. **HCP involvement**: Required signature; they provide shipping info for PAP.[1] Applications support multiple methods for flexibility.[1][2] ## Timeline and Delivery Expect notification in **2-3 weeks** after submission. If approved, medication ships **directly to your home** (or doctor's office if specified). **Reauthorization is required** periodically—your HCP must resubmit before refill.[1][2][3] ## Alternatives if Denied or Ineligible - **Commercially insured**: Pfizer Oncology Together Co-Pay Program (1-877-744-5675; pfizeroncologytogether.com).[3][5][6] - **Government insured**: Apply for Extra Help, Medicaid, or independent foundations (Pfizer assists matching).[3][6] - **Other resources**: Pfizer RxPathways counselors help explore all options; dial 1-844-989-PATH (7284).[2][4] - No biosimilars for XALKORI currently.[program data] ## Reauthorization and Refills Approved patients get temporary supply; reapply via HCP before expiration. Use PAP Connect for status.[1][3][7] ## Disclaimer This guide summarizes publicly available info as of latest data (2026); programs change—verify with Pfizer at (877) 744-5675 or official sites. Not medical/financial advice. Eligibility not guaranteed. Pfizer disclaims liability.[1][2][3]

Program information last verified: March 30, 2026