Page 64 - 2017 V1 InsideOut

P zer Hemophilia Connect: One-Stop Destination to Access All of Our Resources for Eligible Patients
What’s Inside P zer Hemophilia Connect?
• One number with access to all of P zer Hemophilia’s resources and support programs • Financial support programs for eligible patients
• Centralized service for patients, caregivers, and hemophilia treatment centers
• Learn about community resources like HemMobileTM and Patient Affairs Liaisons
1 Get you 2 Activate
3 Bring yo
4 Save yo
Free Trial
Prescription Program
Your eligible patients can receive a one-time, 1-month supply up to 20,000 IU of P zer factor.
For rst-time use by commercially insured patients only. Terms and conditions apply.*
Visit FreeTrialP zerFactor.com to download enrollment forms for your eligible patients.
*See full terms and conditions at P zerHemophiliaResources.com.
Your patients must be currently covered by a private (commercial) insurance plan. For questions about the P zer Hemophilia Trial Prescription Program, please call 1.800.710.1379 or write us at P zer Hemophilia Trial Prescription Program Administrator, MedVantx, PO Box 5736, Sioux
Falls, SD 57117-5736. Your patients may also nd help accessing P zer medicines by contacting the P zer RxPathways® Program.
HemMobileTM
HOW THE CARD WORKS
r prescription for XYNTHA from your doctor.
your Pfizer Factor Access Card by calling the activation number affixed to the card. ur XYNTHA prescription and Pfizer Factor Access Card to a participating pharmacy. ur card and use it for every XYNTHA purchase.
To Pharmacist: For Insured Patients: Et odis ad quam quam doluptae preped maios doluptatio. Ut adiones venditinum adis et omnia asime pellorat.Am volupid quamusdae consent omniat. For Non Insured Patients: Event eatur andi nosandit qui officab ipsunt de plitiatem. Nequod molum quam, consequam rehendipid eaque dolesci. Um qui rempedit, omnis nihil exped quunt disquibusae
Eligible Patients May Save up to $12,000 Per Calendar Year†
The P zer Factor Savings Card can be applied to co-pay, deductible, and coinsurance costs.
Learn more by calling 1.844.989.HEMO (4366) or by visiting HemophiliaSavings.com.
†OFFER TERMS: By using the P zer Factor Savings Card, you acknowledge that you currently meet the eligibility criteria and will comply with the terms and conditions described below:
The Card is not valid for prescriptions that are eligible to be reimbursed, in whole or in part, by Medicaid, Medicare or any other federal or state healthcare programs (including any state prescription drug assistance programs and the Government Health Insurance Plan, available in Puerto Rico, formerly known as “La Reforma de Salud”). The Card is not valid for prescriptions that are eligible to be reimbursed by private insurance plans or other health or pharmacy bene t programs which reimburse you for the entire cost of your prescription drugs. You may receive a total bene t of $12,000 per calendar year, or the amount of your co-pay over one year less a patient nancial responsibility of $10 per month, whichever
is less. You must deduct the value of this offer from any reimbursement requests submitted to your insurance plan either by you or on your behalf. The Card is not valid where otherwise prohibited by law. The Card cannot be combined with any other rebate/coupon, free trial, or similar offer for the speci ed prescription. The Card will be accepted only at participating pharmacies. This Card is not health insurance. Offer good only in the US and Puerto Rico. The Card is limited to 1 per person during this offering period and is not transferable. P zer reserves the right to rescind, revoke, or amend this offer without notice. Offer expires 12/31/17.
No membership fees. Go to P zerFactorSavingsCard.com and download your card today.
Your patients can log their daily activities, infusions, and bleeds, view their logging history,
and send reports to their care team, all right from their phone. HemMobile is available on Google PlayTM or the App Store .
The App Store is a registered trademark
of Apple Inc. Android and Google Play are trademarks of Google Inc.
RxPathways
Program
Do your patients need help accessing P zer medicines? P zer’s RxPathways program may be able to help.
Call 1.888.327.7787 or visit
www.P zerRxPathways.com.
SM
Marketed by Pfizer Inc PP-BEN-USA-0220-01 © 2017 Pfizer Inc. All rights reserved. February 2017
Save up to $12,000
BIN: Group: ID:
Factor Savings Card
This co-pay card is not health insurance.