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Xelsource patient assistance application

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The document is an application for the Pfizer Patient Assistance Program, specifically for XELJANZ® XR (tofacitinib) tablets. It outlines the necessary patient and prescriber information required to apply for assistance, including financial documentation and declarations regarding eligibility. The document also provides important safety information about XELJANZ/XELJANZ XR, including potential serious side effects, contraindications, and monitoring requirements. Additionally, it emphasizes that completing the application does not guarantee assistance and details the program's operational guidelines.

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What is Xelsource?

Psoriatic Arthritis. \u2022 XELJANZ/XELJANZ XR (tofacitinib) is indicated for the treatment of adult patients with active psoriatic arthritis who have had an inadequate response or intolerance to methotrexate or other disease-modifying antirheumatic drugs (DMARDs).

Does Organon have a patient assistance program?

THE ORGANON PATIENT ASSISTANCE PROGRAM FOR RENFLEXIS The Organon Patient Assistance Program provides certain Organon medicines free of charge to eligible patients. The Organon Access Program representative can refer you to the Organon Patient Assistance Program for eligibility determination.

What is patient Assist program?

AssistRx. Patient assistance programs (or PAPs) are generally sponsored by pharmaceutical manufacturers to provide free drug or financial assistance to patients who are uninsured or underinsured.

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