Pfizer Bridge Program: Ngenla

Funded

About

The Pfizer Bridge Program: Ngenla offers substantial benefits to eligible patients who need access to Ngenla medication. This program helps commercially insured individuals in the U.S. and Puerto Rico receive Ngenla at no cost for up to three months during reauthorization or appeals processing. Make the most of the Pfizer Bridge Program: Ngenla to ensure timely access to necessary medication, regardless of insurance delays.

Insurance requirements: Commercially insured, Underinsured

Enrollment Forms

Enrollment Form

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, commercially insured patients may be able to receive medication at no cost for up to three months while they await reauthorization or appeals outcome

•Available in a 30day supply. Refills are subject to limitations

•For NGENLA patients with a new to market block on the medication, NGENLA may be provided for up to 180 days

•HCP and patient should complete the Pfizer Bridge Program Enrollment Form and fax to 8004792562

•For assistance or additional information, call 18006451280, Monday – Friday, 9 am–7 pm ET

Enrollment Forms

Enrollment Form

Other Programs

Ngenla Copay Program

Commercially Insured

Medicare / Medicaid

Underinsured

Uninsured

Max Saving: $6000/year*

12 prescription fills per year*

Pay as low as

$0/ mo

Ngenla Copay Program - Covered benefit

Coverage Required