XYNTHA

Indicated For

Hemophilia A

About This Medication

# Pfizer XYNTHA Patient Assistance Programs Guide: How to Get XYNTHA at Low or No Cost XYNTHA (moroctocog alfa (plasma/albumin-free)) is a recombinant antihemophilic factor used to control and prevent bleeding episodes in patients with hemophilia A. Pfizer offers multiple assistance programs including a free trial for new commercially insured patients, a copay savings card saving up to $12,000 annually, and potential free medication options through Pfizer RxPathways or Hemophilia Connect for uninsured or underinsured patients.[1][2][3][9] ## About XYNTHA **XYNTHA** is an FDA-approved treatment for hemophilia A, a genetic bleeding disorder where blood doesn't clot properly due to factor VIII deficiency. Administered via injection, it replaces the missing clotting factor to manage routine care, surgery, or sudden bleeds. It's plasma- and albumin-free, reducing potential viral transmission risks. Always follow your doctor's dosing instructions, as amounts are based on your weight, bleed severity, and treatment goal—up to 20,000 IU for a one-month trial supply.[1][7] ## Who Qualifies for Assistance? Pfizer provides tiered support based on insurance status: - **Free Trial Program**: First-time XYNTHA users with **commercial insurance** (not Medicare/Medicaid). One-time 1-month supply up to 20,000 IU free. No prior Pfizer factor therapy.[1][2][7] - **Pfizer Factor Savings Card**: Commercially insured patients. Covers copays, deductibles, coinsurance up to **$12,000 per year**. Not for government insurance.[2][4] - **Pfizer RxPathways Patient Assistance Program (PAP)**: Uninsured or government-insured (underinsured) patients meeting income limits—typically **300%-600% of Federal Poverty Level (FPL)** depending on product category (specialty like XYNTHA often higher). Free medicine if eligible.[3] - **Pfizer Hemophilia Connect**: Centralized support including financial aid, insurance help for commercially insured, and free meds for eligible uninsured. Call 1-844-989-HEMO (4366).[4][9] Patients on government programs like Medicare/Medicaid are ineligible for trial/copay but may qualify for PAP.[1][2][3] ## Income Eligibility Breakdown Income limits apply mainly to free medicine PAPs. Exact thresholds for XYNTHA (specialty product) are ~500-600% FPL, but confirm via application as they vary by household size and change yearly. Here's a general table based on 2026 FPL estimates (adjust for actuals): | Household Size | 400% FPL | 500% FPL | 600% FPL | |----------------|----------|----------|----------| | 1 (Individual) | $60,240 | $75,300 | $90,360 | | 2 (Couple) | $81,760 | $102,200| $122,640| | 3 | $103,280| $129,100| $154,920| | 4 | $124,800| $156,000| $187,200| *Notes: Uninsured/underinsured only for PAP. Commercially insured use copay/trial (no income test). Provide proof like tax returns, W-2s, paystubs.[3] ## Insurance Requirements | Program | Insurance Needed | Government Insurance? | |---------|------------------|-----------------------| | Free Trial | Commercial only | No[1][7] | | Savings Card | Commercial only | No[2][4] | | RxPathways PAP | None (uninsured/underinsured) | Yes, if underinsured[3] | | Hemophilia Connect | Varies (commercial for copay, uninsured for free med) | Case-by-case[9] | Commercially insured patients must exhaust insurance coverage; no reimbursement claims allowed for trial product.[7] ## Step-by-Step Application Process 1. **Determine Best Program**: New patient? Try Free Trial. Ongoing copays? Savings Card. Uninsured/low-income? RxPathways or Hemophilia Connect.[1][2][3] 2. **Gather Documents**: - Valid prescription. - Proof of income (W-2, tax return, paystub) for PAP.[3][7] - Insurance info/EOB for copay rebate.[2] - Patient authorization form.[7] 3. **Enroll**: - **Trial**: Doctor downloads form from xyntha.com, completes with Rx, faxes to 1-888-868-8660 or mails to Medvantx, PO Box 5736, Sioux Falls, SD 57117-5736.[7] - **Savings Card**: Enroll at pfizerhemophiliasupport.com/xyntha; get 11-digit ID. Submit EOB/co-pay form to 1-908-548-9260.[2] - **PAP/Hemophilia Connect**: Call 1-844-989-HEMO (M-F 8am-6pm ET) or submit via pfizerrxpathways.com. Doctor's office often helps.[3][4][9] 4. **Submit**: Fax/mail from provider's office for trial.[7] ## Timeline and Delivery - **Trial Processing**: 1-3 weeks; shipped directly by Pfizer administrator.[7] - **Copay**: Instant at pharmacy; rebates processed post-EOB (weeks).[2] - **PAP**: Varies, weeks to months; delivered to doctor/home.[3] Products arrive via mail or pharmacy; track via support line.[4] ## Alternatives if Denied or Ineligible - Switch programs (e.g., copay if trial ineligible). - Pfizer RxPathways copay/savings offers (income-independent).[5] - Partnership for Prescription Assistance (pfizer via helpingpatients.org).[8] - State programs, hemophilia orgs like NHF, or biosimilars (none listed for XYNTHA). - Appeal with updated docs or call support.[9] ## Important Disclaimer This guide summarizes publicly available info as of 2026; eligibility/terms change. Not medical/financial advice. Consult your doctor, pharmacist, or Pfizer (1-844-989-HEMO) for personalized help. Programs may have restrictions; full terms at xyntha.com/pfizerhemophiliasupport.com. Pfizer not liable for application errors.

Program information last verified: March 30, 2026