Xtandi

Indicated For

Castration-resistant prostate cancer (CRPC), metastatic castration-sensitive prostate cancer (mHSPC), non-metastatic castration-resistant prostate cancer (nmCRPC)

About This Medication

# Xtandi (Enzalutamide) Patient Assistance Guide ### Xtandi Support Solutions / Astellas Pharma Support Solutions --- ## Who Qualifies for the Xtandi Support Solutions / Astellas Pharma Support Solutions? If you cannot afford Xtandi (enzalutamide), you may be able to get it at no cost through the **Xtandi Support Solutions / Astellas Pharma Support Solutions** program. This program is run by Astellas, one of the manufacturers of Xtandi, and is designed to help patients who lack adequate prescription coverage or cannot afford their medication. For a single-person household, the maximum annual income to qualify is **$75,300**. Larger households may qualify at higher income levels. To be eligible, you must be **uninsured, underinsured, or enrolled in Medicare Part D** and meet specific financial criteria where no other coverage option exists. Astellas reviews each application individually, so even if you are unsure whether you qualify, it is worth applying. --- ## About Xtandi (Enzalutamide) Xtandi (enzalutamide) is an androgen receptor inhibitor approved by the FDA to treat several forms of prostate cancer, including castration-resistant prostate cancer (CRPC), metastatic castration-sensitive prostate cancer (mHSPC), and non-metastatic castration-resistant prostate cancer (nmCRPC). It is co-developed and marketed by Pfizer and Astellas Pharma. Xtandi is a specialty medication, meaning it is manufactured through a complex process and is not available as a generic or biosimilar. Without insurance or financial assistance, the out-of-pocket cost can reach tens of thousands of dollars per year, making it unaffordable for many patients. The Xtandi Support Solutions program exists specifically to help bridge that gap. --- ## Income Eligibility: Full Breakdown The program generally sets its income limit at **500% of the Federal Poverty Level (FPL)**. The table below shows the maximum annual income allowed based on household size: | Household Size | Max Annual Income | |---|---| | 1 person | $75,300 | | 2 persons | $102,200 | | 3 persons | $129,100 | | 4 persons | $156,000 | If your household has more than four people, the income limit typically increases incrementally for each additional member. Contact the program directly at **(855) 898-2634** to ask about your specific household size. Income is usually verified using your **most recent federal tax return (Form 1040)**, a **W-2**, or **three months of recent pay stubs**. If your income has changed significantly since your last tax filing — for example, due to job loss or retirement — you may be able to submit other documentation to reflect your current financial situation. If your income is above the listed limits, do not assume you are automatically disqualified. Astellas evaluates applications on a **case-by-case basis**, taking medical necessity and financial hardship into account. You may still be considered if you have unusually high medical expenses or other significant financial burdens. --- ## Insurance Requirements Explained Your insurance status plays a major role in whether you qualify. Here is how each situation is handled: - **If you are uninsured:** You are a strong candidate for this program. With no other prescription drug coverage, you may qualify for free medication directly through the patient assistance program. - **If you have Medicare Part D:** You may still qualify. Unlike many other assistance programs, Xtandi Support Solutions has provisions for Medicare Part D enrollees who meet the financial criteria and have no other viable coverage options. Be prepared to provide documentation showing your cost-sharing burden. - **If you have private insurance that covers less than 50% of the cost:** You may be considered underinsured and potentially eligible. The program evaluates whether your coverage leaves you with a significant financial burden that makes the medication unaffordable. - **If you have Medicaid:** Patients with full Medicaid coverage are typically not eligible for this program, since Medicaid is expected to cover the cost of the medication. If Medicaid denies coverage for Xtandi in your state, contact the program to discuss your options. --- ## Step-by-Step: How to Apply Follow these steps to apply for free Xtandi through the patient assistance program: 1. **Gather your documents.** You will need: a completed application form, proof of income (most recent tax return, W-2, or 1040), a valid Xtandi prescription from your doctor, and signatures from both you and your prescribing physician. 2. **Choose your application method.** You have multiple options: - **Apply online** at [https://www.xtandisupportsolutions.com/](https://www.xtandisupportsolutions.com/) - **Call** the program at **(855) 898-2634** to apply by phone or request a paper application - **Fax** your completed application and documents to **(855) 982-6341** 3. **Download or complete the application form.** The application is available on the program website. Print it, complete all fields, and make sure both patient and physician sections are fully signed. 4. **Submit your income documentation.** Attach your most recent tax return or other approved income documents to your application. 5. **Have your doctor's office involved.** Your prescriber must sign the application. Many doctor's offices are familiar with this process, so ask your oncology care team for help if needed. 6. **Track your application.** After submitting, you can call **(855) 898-2634** to check on your application status. The program typically completes its review within **two business days**. --- ## What to Expect: Timeline and Delivery Once your application is submitted, the program typically completes its review within **two business days**. You or your doctor's office will be notified of the approval decision. If approved, Xtandi is **shipped directly to your home** — you do not need to pick it up at a pharmacy or your doctor's office. There is nothing you need to do at the time of delivery other than be available to receive the shipment. Approval is not permanent. The program requires **annual reauthorization**, meaning you will need to reapply each year to continue receiving your medication. Your care team or a program representative will typically notify you when it is time to renew. --- ## Alternatives If You Don't Qualify If you do not meet the eligibility requirements for the patient assistance program, there are other options to explore: 1. **Biosimilars:** There are currently **no FDA-approved biosimilar alternatives** to Xtandi (enzalutamide). This option is not available at this time. 2. **Manufacturer savings card (insured patients):** If you have commercial insurance, you may qualify for the Xtandi savings card program, which can reduce your out-of-pocket costs. Visit [https://www.xtandi.com/patient-savings-program](https://www.xtandi.com/patient-savings-program) to learn more and enroll. 3. **State Pharmaceutical Assistance Programs (SPAPs):** Many states offer their own prescription assistance programs for residents who do not qualify for federal programs. Search your state's health department website or ask your social worker for information about programs in your area. 4. **NeedyMeds.org:** This free, independent database lists hundreds of patient assistance programs, drug discount cards, and state programs. Visit [https://www.needymeds.org](https://www.needymeds.org) to search for additional help with Xtandi or other medications. --- > *This guide is for informational purposes only and does not constitute medical or legal advice. Eligibility determinations are made solely by Pfizer / Astellas. Program terms may change — verify current requirements at [https://www.xtandi.com/support](https://www.xtandi.com/support) before applying.* ---

Program information last verified: February 27, 2026