Pfizer Trial Prescription Program: BeneFix

Funded

About

The Pfizer Trial Prescription Program: BeneFix provides an exceptional opportunity for first-time commercially insured patients to access BeneFIX at no cost. This program ensures patients receive up to 20,000 IU of BeneFIX delivered directly to their home, simplifying the process of accessing this vital medication. With Pfizer Trial Prescription Program: BeneFix, patients can experience the benefits of their treatment without the immediate financial burden, provided they meet the eligibility criteria.

Insurance requirements: Commercially insured, Underinsured

Enrollment Forms

Enrollment Form

Benefits

•1 maximum fills per year

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: No

•Activation Required: No

Program Details

•Eligible patients can get up to 20,000 IU of BeneFix shipped directly to their home

•Patients should take their completed enrollment form to their HCP to fax to 8888688660

•Enrollment form, prescription and patient authorization form can also be mailed to Pfizer Factor Product Trial Prescription Program Administrator, Medvantx, PO Box 5736, Sioux Falls, SD 571175736

•Only 1 offer per person; offer expires 1 month from enrollment date or when the 20,000 IU at no cost has been reached

•The free trial offer cannot be combined with any other rebate/coupon, free trial, or similar offer for the prescribed prescription

•Call 8449894366 for assistance or additional information

Enrollment Forms

Enrollment Form