Enroll your patients to help them with access resources and support
$0 Copay Savings Card
The Copay Savings Card may reduce out-of-pocket costs for eligible, commercially insured patients prescribed CIBINQO. With the Copay Savings Card,* eligible commercially insured patients:
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Interim Care Rx |
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Live support |
*Eligibility required. No membership fees. The maximum benefit per patient is $15,000 per calendar year. Only for use with commercial insurance. If you are enrolled in a state or federally funded prescription insurance program, you may not use the copay card. Terms and conditions apply.
†The free product for this program is for certain commercially insured patients only. Not available to residents in the states of MA, MI, MN, MO, OH, or RI. See terms and conditions.
‡Some offerings are provided through third-party organizations that operate independently and are not controlled by Pfizer. Availability of offerings and eligibility requirements are determined solely by these organizations.
e-Prescribe directly to Sonexus Health Pharmacy Services|| |
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HCP Portal: Log in or register at |
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Fax a completed and signed enrollment form to |
To learn more, call 1-844-496-8707, Monday-Friday, 8:00 AM to 8:00 PM ET
§A link to enroll patients appears in the EHR during the e-prescribing process. How you are directed to the form is controlled by, and varies based on, your EHR channel partner.
||If you choose to ePrescribe directly to Sonexus Health Pharmacy Services, you are certifying that you have received patient consent for Sonexus Health Pharmacy Services and Pfizer Dermatology Patient AccessTM to contact your patient and provide them services. Sonexus Health Pharmacy Services is categorized as a mail-order pharmacy in EMR/EHR systems and is located at 2730 S. Edmonds Lane, Suite 400, Lewisville, TX 75067.
Complete, print, and fax to enroll patients in the Pfizer Dermatology Patient AccessTM program.
** This is an optional area where footnotes can live.
Complete, print, and fax to register to enroll patients in Pfizer Dermatology Patient AccessTM via the HCP Portal.
** This is an optional area where footnotes can live.
Complete, print, and mail or fax to help patients apply for free medication.
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Examples when requesting coverage from patients’ insurance providers.
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¶PFIZER PATIENT ASSISTANCE PROGRAM ELIGIBILITY CRITERIA
The Pfizer Patient Assistance Program is not health insurance and is available for eligible uninsured/underinsured patients only. Offer is only available to patients who meet financial and other criteria. This offer does not require, nor will it be made contingent on, purchase requirements of any kind. No claim for reimbursement or credit for any costs associated with the medicine(s) may be submitted to any prescription insurance provider or payer, including Medicare Part D plans. Pfizer reserves the right to amend, rescind, or discontinue this program at any time without notification. Offer good only in the U.S. and Puerto Rico. Patient must be a resident of the U.S. or Puerto Rico. Prescription must be provided by a healthcare provider licensed in the U.S. or Puerto Rico. Patient must be treated in the outpatient setting of care. Additional eligibility criteria may apply. Contact Pfizer Dermatology Patient Access for details.
Get your eligible, commercially insured patients started
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Ready to get a patient started?
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Connect with an eRep to learn more about CIBINQO
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CIBINQO (abrocitinib) is indicated for the treatment of adults with refractory, moderate-to-severe atopic dermatitis whose disease is not adequately controlled with other systemic drug products, including biologics, or when use of those therapies is inadvisable.
Limitations of Use: CIBINQO is not recommended for use in combination with other JAK inhibitors, biologic immunomodulators, or with other immunosuppressants.
CIBINQO is indicated for the treatment of adults with refractory, moderate-to-severe atopic dermatitis whose disease is not adequately controlled with other systemic drug products, including biologics, or when use of those therapies is inadvisable.
Limitations of Use: CIBINQO is not recommended for use in combination with other JAK inhibitors, biologic immunomodulators, or with other immunosuppressants.