Xtandi Patient Savings Program

Funded

About

The Xtandi Patient Savings Program is designed to provide significant financial assistance to patients prescribed with Xtandi, helping them to reduce out-of-pocket prescription expenses. The program offers eligible commercially insured patients the opportunity to pay as little as $0 per prescription with a copay assistance limit of $7,000 per calendar year. The Xtandi Patient Savings Program ensures that more patients can afford and access the Xtandi drug product for FDA-approved indications.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

Benefits

•$7000 annual maximum benefit

•12 maximum fills per year

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Must be 18 years of age or older

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: No

•Activation Required: No

Program Details

•Eligible commercially insured patients may pay as little as $0 per prescription

•Program has a maximum copay assistance limit of $7,000 per calendar year

•HCPs can initiate the enrollment process on behalf of their patients by going to http://xtandicopayenroll.com; patient will be notified by email that their HCP has initiated Program enrollment, and be provided with instructions on how to complete the enrollment process

•For assistance or additional information, call 8552178311, Monday – Friday, 8 AM – 8 PM ET

Enrollment Forms

Enrollment Form

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