XALKORI

Indicated For

Non-small cell lung cancer (NSCLC), anaplastic lymphoma kinase (ALK)-positive

About This Medication

# Pfizer Patient Assistance Program Guide: How to Get XALKORI at Low or No Cost ## About This Program The Pfizer Patient Assistance Program (PAP) helps eligible patients access XALKORI (crizotinib) at little or no cost. XALKORI is a targeted cancer medication used to treat anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC). This guide explains how to apply and what to expect. ## What is XALKORI? XALKORI is a prescription medication called a tyrosine kinase inhibitor. It's designed to target and slow the growth of cancer cells in patients with ALK-positive NSCLC. Because this is a specialty cancer medication, it can be expensive. The Pfizer Patient Assistance Program exists to make sure cost doesn't prevent you from getting the treatment your doctor prescribed. ## Who Can Apply? You may qualify for XALKORI assistance if you: - Have a valid prescription for XALKORI from your doctor - Are a U.S. resident (including Puerto Rico) - Meet income requirements (see table below) - Have one of these insurance situations: - **Uninsured** (no health insurance) - **Underinsured** (have insurance but high out-of-pocket costs) - **Commercially insured** (have private health insurance) ### Who Cannot Apply for the Free Medication Program You are **not eligible** for the free medication assistance if you have: - Medicare coverage - Medicaid coverage - TRICARE (military insurance) - Veterans Affairs (VA) benefits - Coverage through state prescription drug assistance programs - Government health insurance plans in Puerto Rico **However**, if you have Medicare or Medicaid, you may still qualify for the **co-pay card** to help reduce your out-of-pocket costs. See the "Co-Pay Card Option" section below. ## Income Eligibility Guidelines Your household income must fall within the limits below. Income limits vary based on household size: | Household Size | Maximum Annual Income | |---|---| | 1 person | Varies* | | 2 people | Varies* | | 3 people | Varies* | | 4 people | Varies* | | 5 people | Varies* | | 6+ people | Varies* | *Income thresholds are reviewed regularly and may vary. Contact Pfizer at **1-844-989-PATH (7284)** for current income limits that apply to your household size, or ask during your application. Income includes: - Wages and salaries - Self-employment income - Social Security and retirement benefits - Unemployment benefits - Child support or alimony - Disability payments ## Step-by-Step Application Instructions ### Step 1: Gather Required Documents Before you start, collect: 1. **Valid prescription for XALKORI** from your doctor 2. **Front and back of your medical insurance card** (if you have insurance) 3. **Front and back of your pharmacy insurance card** (if different from medical) 4. **Medicare ID Number** (HICN or MBI) — if applicable 5. **Completed enrollment form** with your financial information ### Step 2: Choose Your Application Method You can apply in multiple ways: **By Phone:** - Call **1-844-989-PATH (7284)** - Representatives are available to help you through the entire process - Have your documents ready when you call **Online:** - Visit **https://www.pfizeroncologytogether.com/patient** - Complete the application form on the website - You can upload documents or mail them **By Mail:** - Request an application by phone or online - Complete the form and mail it with copies of required documents - Include a copy of your prescription ### Step 3: Provide Your Information You'll need to provide: - Personal information (name, address, date of birth, contact details) - Insurance information (from your insurance cards) - Financial information (income, household size, expenses if requested) - Your doctor's information and prescription details ### Step 4: Submit Your Application - Submit online, by phone, or by mail - Keep a record of your application number - Save contact information for follow-up questions ### Step 5: Wait for Approval - The program typically processes applications in **4-8 weeks** - You'll be contacted if additional information is needed - Approval is based on income eligibility and insurance status ### Step 6: Receive Your Medication Once approved: - XALKORI will be **shipped directly to you** or your pharmacy - You'll receive instructions on how to pick up or receive your medication - Your approval may include multiple shipments or a set supply period ## Co-Pay Card Option If you have Medicare, Medicaid, TRICARE, VA benefits, or other government insurance, you **cannot** use the free medication program. However, you may qualify for a **co-pay card** to reduce your out-of-pocket costs. Visit **https://xalkori.pfizerpro.com/financial-assistance** to learn about and apply for the co-pay card. The co-pay card can: - Reduce your monthly co-pay to as little as $0-$25 per month - Apply to commercially insured patients and some government-insured patients - Work at most U.S. pharmacies ## What to Expect: Timeline and Delivery | Step | Timeline | |---|---| | Application submission | Immediate | | Processing and review | 4-8 weeks typical | | Approval notification | Via phone/email/mail | | Medication shipment | Within 1-2 weeks of approval | | Delivery to you | Via mail or pharmacy pickup | **Note:** If additional information is needed, processing may take longer. Pfizer will contact you if there are any delays. ## Reauthorization Your assistance may need to be renewed periodically as required by Pfizer. You'll be notified when reauthorization is needed. Simply follow the same process to renew your enrollment. ## What If My Application Is Denied? If you don't qualify for the free medication program, you have other options: 1. **Apply for the co-pay card** at https://xalkori.pfizerpro.com/financial-assistance 2. **Check your insurance benefits** — your insurance may cover XALKORI with a co-pay 3. **Ask your doctor** about other treatment options or clinical trials 4. **Contact 211.org** — a free service that connects you to local assistance programs 5. **Visit NeedyMeds.org** — a comprehensive database of patient assistance programs 6. **Call your state's pharmaceutical assistance program** — many states offer help with medication costs ## Contact Information **Pfizer Patient Assistance Program:** - Phone: **1-844-989-PATH (7284)** - Website: **https://www.pfizeroncologytogether.com/patient** - Hours: Monday-Friday, 9 AM-9 PM ET **Co-Pay Card Information:** - Website: **https://xalkori.pfizerpro.com/financial-assistance** ## Important Disclaimer This guide is for informational purposes only and does not constitute medical advice. Requirements, income limits, and program terms may change. For the most current information, contact Pfizer directly at the number above. Your doctor can help determine if XALKORI is the right treatment for your condition. If you have questions about your eligibility or the application process, contact Pfizer Patient Assistance at the phone number or website listed above. ## Privacy and Confidentiality Your personal and financial information is kept confidential. Pfizer uses your information only to determine eligibility and deliver medication. You will not be shared with pharmaceutical companies or other organizations without your permission.

Program information last verified: March 25, 2026