Xeljanz

Indicated For

rheumatoid arthritis, psoriatic arthritis, ulcerative colitis

About This Medication

# Pfizer Patient Assistance Program Patient Guide: How to Get Xeljanz (tofacitinib) at Low or No Cost Xeljanz (tofacitinib) is a prescription medication used to treat certain inflammatory conditions like rheumatoid arthritis, psoriatic arthritis, ulcerative colitis, ankylosing spondylitis, and polyarticular course juvenile idiopathic arthritis in adults and children 2 years and older. The **Pfizer Patient Assistance Program (PAP)** provides Xeljanz at no cost to eligible uninsured or underinsured patients who meet income and other criteria, often coordinated through **XELSOURCE**, Pfizer's support hub. This guide explains everything you need to know about qualifying for and applying to the program in simple terms. It's designed for patients like you—facing high medication costs while managing a serious health condition. Always consult your doctor for personalized advice. ## Who Qualifies for the Pfizer Patient Assistance Program for Xeljanz? The program helps **uninsured or underinsured patients** who cannot afford their medication. Key eligibility points include: - **Residency**: You must live in the United States, Puerto Rico, or U.S. Virgin Islands. - **Treatment Setting**: Must be prescribed for outpatient use by a U.S.-licensed healthcare provider. - **Insurance Status**: Primarily for those without commercial insurance. Government insurance patients (like Medicare or Medicaid) are referred to other programs first, such as Medicare Extra Help or Medicaid.[2][3] - **Income**: Based on household income, typically at or below a certain percentage of the Federal Poverty Level (FPL), though exact thresholds for Xeljanz are not publicly detailed on the product site. Eligibility is determined case-by-case via XELSOURCE referral.[1] **Important**: Commercially insured patients do not qualify for free medicine through PAP but may use the Xeljanz Co-Pay Savings Program instead.[3] ## About Xeljanz (tofacitinib) **Xeljanz** is a Janus kinase (JAK) inhibitor that helps reduce inflammation and immune system overactivity. It's available as immediate-release tablets (5 mg, 10 mg, 20 mg), extended-release tablets (Xeljanz XR: 11 mg, 22 mg), or oral solution for children. Common uses: - Moderate to severe rheumatoid arthritis (after TNF blockers fail) - Psoriatic arthritis - Ulcerative colitis - Ankylosing spondylitis - Polyarticular course juvenile idiopathic arthritis **Key Safety Note**: Xeljanz can increase risks of serious infections, blood clots, certain cancers, and heart problems. Discuss risks with your doctor and report symptoms like fever, swelling, or chest pain immediately.[2] ## Income Eligibility Breakdown Specific income limits for the Pfizer PAP are not listed on Xeljanz sites but follow general Pfizer guidelines, often up to 400-500% FPL depending on household size and program. For Xeljanz, eligibility is assessed after referral via XELSOURCE; no fixed thresholds are detailed publicly.[1][3] Here's a general reference table for Federal Poverty Level (FPL) guidelines (2026 estimates; check current at ASPE.hhs.gov): | Household Size | 100% FPL | 300% FPL | 400% FPL | 500% FPL | |----------------|----------|----------|----------|----------| | 1 (Individual) | $15,060 | $45,180 | $60,240 | $75,300 | | 2 (Couple) | $20,440 | $61,320 | $81,760 | $102,200| | 3 | $25,820 | $77,460 | $103,280| $129,100| | 4 | $31,200 | $93,600 | $124,800| $156,000| *Add ~$5,380 per additional person. Pfizer PAP often uses up to 400-500% FPL, but confirm via phone as Xeljanz specifics vary. Proof of income required (e.g., tax return, W-2, pay stubs).[3]* ## Insurance Requirements - **Uninsured**: Primary candidates; may need to apply to Medicaid first if eligible.[2][3] - **Underinsured**: Limited coverage or high copays; government plans referred elsewhere initially. - **Commercial Insurance**: Not eligible for PAP; use Co-Pay Card (up to $16,000/year savings).[2] - **Medicare**: Enroll in Medicare Prescription Payment Plan if applicable; referred to Extra Help first.[3] XELSOURCE handles benefits investigation to confirm your status.[1] ## Step-by-Step Application Process 1. **Contact XELSOURCE**: Call **(844) 935-5269** for uninsured/underinsured referral to PAP. They investigate benefits and guide you.[1][2] 2. **Get Referred to Pfizer RxPathways**: Use www.PfizerRxPathways.com or call 1-844-989-PATH (7284). Search for Xeljanz and start application.[3][6] 3. **Complete Enrollment**: Doctor faxes Prescription & Enrollment Form to XELSOURCE (1-866-297-3471). Provide: - Valid prescription - Proof of income (W-2, tax return, pay stubs) - Proof of residency (utility bill, etc.) - Benefits investigation summary[1][3] 4. **Submit via Phone or Online**: Pfizer PAP applications via phone or Pfizer PAP Connect (for select meds).[6] 5. **Wait for Approval**: 2-3 weeks typically.[3][6] Your doctor or XELSOURCE Pfizer Patient Access Coordinator (PAC) can assist.[1] ## Timeline and Delivery - **Processing**: 2-3 weeks after full submission.[3][6] - **Reauthorization**: Required periodically; resubmit docs before refill.[1] - **Delivery**: Shipped free to your home via specialty pharmacy (e.g., Sonexus Health).[1] Track status at xelsourcepatientportal.com.[2] ## Alternatives if Denied or Ineligible - **Co-Pay Savings**: Commercial insurance; call XELSOURCE.[2] - **Medicaid/Extra Help**: Government referrals.[2][3] - **Pfizer RxPathways Other Options**: State programs, generics (no biosimilars for Xeljanz).[3] - **Appeals**: XELSOURCE helps with PA/denial appeals.[1] - **NeedyMeds or RxAssist**: Additional resources.[8] ## Disclaimer This guide is for informational purposes only and based on publicly available data as of 2026. Program details can change; eligibility not guaranteed. Contact Pfizer directly for latest info. Not medical advice—speak to your healthcare provider. Pfizer reserves rights to modify terms.[1][2][3] (Word count: 1028)

Program information last verified: March 25, 2026