XELJANZ XR

Indicated For

Rheumatoid Arthritis, Ulcerative Colitis

About This Medication

# Pfizer Patient Assistance Program Patient Guide: How to Get XELJANZ XR at Low or No Cost XELJANZ XR (tofacitinib extended-release) is a prescription medication used to treat certain inflammatory conditions like rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis in adults. The **Pfizer Patient Assistance Program** provides eligible uninsured or underinsured patients with XELJANZ XR at no cost, helping those who struggle to afford their medication.[2][3][4] ## About XELJANZ XR **XELJANZ XR** is an oral tablet taken once daily, belonging to a class of drugs called Janus kinase (JAK) inhibitors. It works by blocking enzymes that cause inflammation, reducing joint pain, swelling, and damage in conditions like rheumatoid arthritis (RA) or psoriatic arthritis (PsA). It's also approved for adults with moderately to severely active ulcerative colitis (UC) who haven't responded well to other treatments. Common side effects include infections, headaches, diarrhea, and high cholesterol; serious risks include infections, blood clots, heart problems, and cancer. Always discuss risks with your doctor and report side effects to Pfizer at 1-800-438-1985.[1][3][6] This guide explains how to access free XELJANZ XR through Pfizer's program if you qualify. It's designed for patients, but involve your healthcare provider—they can help with applications and prescriptions.[2] ## Who Qualifies? The program targets **uninsured or underinsured patients** in the US, Puerto Rico, or US Virgin Islands, treated outpatient by a US-licensed provider. You must have a valid prescription and meet income and other criteria. **Commercially insured patients do not qualify**—they may use the XELJANZ Co-Pay Savings Program instead.[3][4][7] Key requirements: - Live in the US, PR, or USVI. - Valid outpatient prescription. - Uninsured/underinsured (government insurance patients try Extra Help/Medicaid first).[3][4] ## Income Eligibility Specific income thresholds aren't publicly detailed online; eligibility uses **Federal Poverty Level (FPL)** guidelines or similar, with criteria subject to change. Contact the program for your household size. Provide proof like W-2, pay stubs, or tax returns.[4] | Household Size | Estimated Threshold | Notes | |---------------|---------------------|-------| | Individual | Contact program | Based on FPL; exact % not specified | | Couple | Contact program | Eligibility criteria apply | | Family of 3 | Contact program | Proof of income required | | Family of 4+ | Contact program | Call for details | Notes: "Eligibility criteria apply; contact program for details." Updates may occur—verify current limits.[4] ## Insurance Requirements - **No insurance**: Eligible if income-qualified; try Medicaid first if applicable.[3] - **Government insurance** (Medicare/Medicaid): Referred to Medicare Extra Help or Medicaid initially. If denied, then evaluated for Pfizer PAP.[3][4] - **Commercial/private insurance**: Not eligible for PAP; use co-pay card (up to $15,000/year savings).[4][7] - Underinsured patients may qualify if out-of-pocket costs are unaffordable.[3] XELSOURCE (1-844-935-5269) helps check coverage, prior authorizations, and appeals.[1][3] ## Step-by-Step Application Process 1. **Check eligibility**: Call **1-844-935-5269** (XELSOURCE, Mon-Fri 8am-9pm ET) or 1-844-989-PATH (7284) for Pfizer RxPathways. Discuss with your doctor.[1][2][4] 2. **Start application**: Visit www.PfizerRxPathways.com, enter "XELJANZ XR," and follow prompts. Use Pfizer PAP Connect for online apps or manual process.[2][4] 3. **Gather documents**: Prescription, proof of income (W-2, stubs, tax return), ID. Doctor completes enrollment form.[1][4] 4. **Submit**: Doctor faxes Prescription & Enrollment Form to 1-866-297-3471 or use e-platform. Mail/fax opt-in forms if needed.[1][2] 5. **Wait for decision**: Notified in **2-3 weeks**.[2] 6. **Receive medication**: Shipped free to your home if approved.[3] Your doctor or Pfizer Access Coordinator (PAC) can assist.[1] ## Timeline and Delivery - **Processing**: 2-3 weeks for enrollment status.[2] - **Delivery**: Shipped directly to patient—no pharmacy pickup.[3] - **Refills**: Reauthorization likely needed annually or per terms; submit updated info.[7] Call for status updates. Interim programs may provide short-term supply during appeals.[7] ## Alternatives if Denied - **Appeal denial**: XELSOURCE provides forms, contacts for prior auth/appeals.[1] - **Other programs**: Medicaid, Medicare Extra Help, or state assistance.[3] - **Co-pay card**: For commercial insurance (private pay ineligible).[5][7] - **Patient Access Network (PAN) Foundation** or NeedyMeds for broader aid. - **Biosimilars**: None listed for XELJANZ XR. - **Switch to XELJANZ** (immediate-release) if appropriate—no extra approvals needed.[3] ## Important Disclaimer This guide is for informational purposes only and not a substitute for professional medical/financial advice. Program details change; eligibility not guaranteed. Contact Pfizer directly for latest info. Pfizer PAP isn't insurance. See full terms at PfizerRxPathways.com. Always consult your doctor before starting/stopping XELJANZ XR. Serious risks include infections, clots—discuss fully.[1][6][7] (Word count: 942)

Program information last verified: March 30, 2026