SUPPORT & FINANCIAL ASSISTANCE
SUPPORT & FINANCIAL ASSISTANCE

Specialty Pharmacies:
An
Extension of Your
BOSULIF®
(bosutinib) Support
Network

Specialty pharmacies are like traditional pharmacies that you are used to, but they
offer additional services for patients, including prescriptions available by mail order
and delivered to your home for added convenience.

Pfizer will work with your doctor to find a specialty pharmacy that takes your insurance.
For more information, please call 1-877-744-5675 or visit PfizerOncologyTogether.com.

Making your support needs a priority. Together.

At Pfizer Oncology Together, we treat your individual needs as a priority. We’ll help you identify financial assistance
options so you can get your prescribed Pfizer Oncology medicine. We’ll also connect you with a dedicated Care
Champion who has social work experience and can provide resources that may help with some of your day-to-day
challenges. Because when it comes to support, we’re in this together. For live, personalized support, 
call 1-877-744-5675.

Finding resources for your 
day-to-day. Together.

Managing day-to-day life after diagnosis can be overwhelming, but
you don’t have to do it alone. With Pfizer Oncology Together, you’ll
have a dedicated Care Champion who has social work experience.
Your Care Champion will talk with you one-on-one in order to
provide you with resources to help with some of the day-to-day
challenges you may be facing.a

Emotional Support

Find resources for emotional support and other daily 
challenges. These resources include support groups, an
independent organization’s helpline, and a free app
designed to help you connect with loved ones.

Transportation and Lodging

Connect to an independent organization that helps eligible patients
find rides and lodging for treatment-related appointments.

Workplace Guidance

Receive information to help you prepare for leaving
or returning to work after being diagnosed.

Ongoing Education

Get guidance on living with your condition, including nutritional
information, communication tips, and toolkits specific to your
prescribed medicine.

Want to sign up for Care
Champion support?
(Optional)

Our dedicated Care Champions, who have social
work experience, can provide you with resources
that may help with some of your daily challenges.
To get started, click here to visit the Pfizer
Oncology Together Website.

aSome services are provided through third-party organizations that operate independently and are not controlled by Pfizer.
Availability of services and eligibility requirements are determined solely by these organizations.

Support_CareChampion_Banner_1

Learning about financial assistance. Together.

Finding ways to save on your medicine can be confusing. But it may be easier if you’re able to research options together.
Pfizer Oncology Together can help you understand your insurance and identify what financial support may be available for
your prescribed BOSULIF. In addition, we can help find a specialty pharmacy that can fill your prescription.

SELECT AN INSURANCE STATUS

Commercially Insured
Support_POTcard_Graphic

Resources for eligible commercial, private, employer, and
state health insurance marketplace patients:

Co-pay assistance: Eligible, commercially insured patients
may pay as little as $0 per month for BOSULIF.b There are
no income requirements, forms, or faxing to enroll.

bLimits, terms, and conditions apply. Patients are not eligible to use this card if they are enrolled in a state or federally funded insurance program, including
but not limited to Medicare, Medicaid, TRICARE, Veterans Affairs healthcare, a state prescription drug assistance program, or the Government Health
Insurance Plan available in Puerto Rico. Patients may receive up to $25,000 in savings annually. The offer will be accepted only at participating
pharmacies. This offer is not health insurance. No membership fees apply. Pfizer reserves the right to rescind, revoke, or amend this offer without notice.
For any questions, please call 1-877-744-5675, visit PfizerOncologyTogether.com/terms or write: Pfizer Oncology Together Co-Pay Savings Program, 2250
Perimeter Park Drive, Suite 300, Morrisville, NC 27560.

Medicare/Government Insured
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Help identifying resources for eligible patients with Medicare/Medicare Part D, Medicaid, and other government insurance plans:

  • Assistance with searching for support from independent charitable foundations:
    These foundations exist independently of Pfizer and have their own eligibility 

    criteria and application processes. Availability of support from the foundations is
    determined solely by the foundations
  • Financial assistance through Extra Help, a Medicare Part D Low-Income Subsidy
    (LIS) program
  • Free medicinec

c If support from independent charitable foundations or Medicare Extra Help is not available, Pfizer Oncology Together will provide eligible patients with
medication for free through the Pfizer Patient Assistance Program. The Pfizer Patient Assistance Program is a joint program of Pfizer Inc. and the Pfizer
Patient Assistance Foundation™. The Pfizer Patient Assistance Foundation is a separate legal entity from Pfizer Inc. with distinct legal restrictions.

Uninsured
Support_Uninsured_Icon

Help identifying resources for eligible patients without any
form of healthcare coverage:

  • Help finding coverage
  • Free medicine through the Pfizer Patient Assistance Program,
    or at a savings through the Pfizer Savings Programd

d The Pfizer Savings Program is not health insurance. For more information, call the toll-free
number 1-877-744-5675.
There are no membership fees to participate in this program.
Estimated savings are 50% and depend on such factors as the particular drug purchased,
amount purchased, and the pharmacy where purchased.

FOR LIVE, PERSONALIZED SUPPORT

Call 1-877-744-5675 (Monday–Friday 8 AM–8 PM ET)

Co-Pay Card Terms and Conditions

By using this co-pay card, you acknowledge that you currently meet the eligibility criteria and will comply with the Terms
and Conditions described below:

  • Patients are not eligible to use this card if they are enrolled in a state or federally funded insurance program, including but
    not limited to Medicare, Medicaid, TRICARE, Veterans Affairs healthcare, a state prescription drug assistance program, or
    the Government Health Insurance Plan available in Puerto Rico (formerly known as “La Reforma de Salud”).
  • Patient must have private insurance. Offer is not valid for cash-paying patients.
  • With this card, eligible patients will pay a $0 co-pay per eligible monthly prescription, subject to a maximum amount of
    $25,000 per calendar year. The amount of any benefit is the difference between your co-pay and $0. After the annual
    maximum of $25,000 is reached, you will be responsible for the remaining monthly out-of-pocket costs. This card may not
    be redeemed more than once per 30 days.
  • This co-pay card is not valid when the entire cost of your prescription drug is eligible to be reimbursed by your private
    insurance plan or other private health or pharmacy benefit programs.
  • You must deduct the value of this co-pay card from any reimbursement request submitted to your insurance plan, either
    directly by you or on your behalf.
  • You are responsible for reporting use of the co-pay card to any private insurer, health plan, or other third party who pays for
    or reimburses any part of the prescription filled using the co-pay card, as may be required. You should not use the co-pay
    card if your insurer or health plan prohibits use of manufacturer co-pay cards.
  • You must be 18 years of age or older to redeem the co-pay card.
  • This co-pay card is not valid where prohibited by law.
  • Card cannot be combined with any other savings, free trial, or similar offer for the specified prescription.
  • Card will be accepted only at participating pharmacies.
  • This card is not health insurance.
  • Offer good only in the U.S. and Puerto Rico.
  • Card is limited to 1 per person during this offering period and is not transferable.
  • No other purchase is necessary.
  • Data related to your redemption of the co-pay card may be collected, analyzed, and shared with Pfizer for market research
    and other purposes related to assessing Pfizer’s programs. Data shared with Pfizer will be aggregated and de-identified; it
    will be combined with data related to other co-pay card redemptions and will not identify you.
  • Pfizer reserves the right to rescind, revoke, or amend this offer without notice.
  • Offer expires 12/31/2020.
  • If your pharmacy does not participate, you may be able to submit a request for a rebate in connection with this offer. Mail
    a copy of the patient’s pharmacy receipt indicating patient name, name of medication purchased, price paid, and date
    purchased, along with a copy of the patient’s Pfizer Oncology Together Co-Pay Savings Card, to:

Pfizer Oncology Together Co-Pay Savings Program
2250 Perimeter Park Drive, Suite 300
Morrisville, NC 27560
 

Important Information: Embedded Bottom

Important Safety Information And Indications

Do not take BOSULIF if you are allergic to bosutinib or any of the ingredients in BOSULIF.
Before you take BOSULIF, tell your doctor if you:
  • have liver problems
  • have heart problems
  • have kidney problems
  • have any other medical conditions
  • are pregnant or plan to become pregnant. BOSULIF can harm your unborn baby. Tell your doctor right away if you become pregnant while taking BOSULIF
    • Females who are able to become pregnant should have a pregnancy test before starting treatment with BOSULIF and should use effective birth control (contraception) during treatment with BOSULIF and for at least 2 weeks after the last dose. Talk to your doctor about birth control methods that may be right for you
  • are breastfeeding or plan to breastfeed. It is not known if BOSULIF passes into your breast milk or if it can harm your baby. Do not breastfeed during treatment with BOSULIF and for at least 2 weeks after the last dose

Tell your doctor about the medicines you take, including prescription medicines, nonprescription medicines, vitamins, and herbal supplements. BOSULIF and certain other medicines can affect each other.

BOSULIF may cause serious side effects, including:
  • Stomach problems. BOSULIF may cause stomach (abdomen) pain, nausea, diarrhea, vomiting, or blood in your stools. Get medical help right away for any stomach problems
  • Low blood cell counts. BOSULIF may cause low platelet counts (thrombocytopenia), low red blood cell counts (anemia), and low white blood cell counts (neutropenia). Your doctor should do blood tests to check your blood cell counts regularly during your treatment with BOSULIF. Call your doctor right away if you have unexpected bleeding or bruising, blood in your urine or stools, fever, or any signs of an infection
  • Liver problems. BOSULIF may cause liver problems. Your doctor should do blood tests to check your liver function regularly during your treatment with BOSULIF. Call your doctor right away if your skin or the white part of your eyes turns yellow (jaundice) or you have dark “tea color” urine
  • Heart problems. BOSULIF may cause heart problems, including heart failure. Get medical help right away if you get shortness of breath, weight gain or swelling in your hands, ankles or feet
  • Your body may hold too much fluid (fluid retention). Fluid may build up in the lining of your lungs, the sac around your heart, or your stomach cavity. Get medical help right away if you get any of the following symptoms during your treatment with BOSULIF:

shortness of breath and cough

chest pain

swelling in your hands, ankles, or feet

swelling all over your body

weight gain

  • Kidney problems. BOSULIF may cause kidney problems. Your doctor should do tests to check your kidney function when you start treatment with BOSULIF and during your treatment. Call your doctor right away if you get any of the following symptoms during your treatment with BOSULIF:

you urinate more or less often than normal

you make a much larger or smaller amount of urine than normal

The most common side effects of BOSULIF for those patients who are newly diagnosed include: diarrhea, nausea, low platelet counts, rash, stomach pain, and changes in liver function tests.

The most common side effects of BOSULIF for those patients who no longer benefit from or did not tolerate other treatment include: diarrhea, nausea, stomach pain, rash, low platelet counts, vomiting, low red blood cell counts, tiredness, fever, cough, headache, changes in liver function tests, and swelling.

Tell your doctor or get medical help right away if you get respiratory tract infections, loss of appetite, headache, dizziness, back pain, joint pain, or itching while taking BOSULIF. These may be symptoms of a severe allergic reaction.

Your doctor may change your dose, temporarily stop, or permanently stop treatment with BOSULIF if you have certain side effects.

BOSULIF may cause fertility problems in both female and male patients. This may affect your ability to have a child. Talk to your doctor if this is a concern for you.

Tell your doctor if you have any side effect that bothers you or that does not go away. These are not all of the possible side effects of BOSULIF. For more information, ask your doctor or pharmacist. You may report side effects to FDA at 1-800-FDA-1088.

INDICATIONS

BOSULIF is a prescription medicine used to treat adults who have a certain type of leukemia called Philadelphia chromosome–positive chronic myelogenous leukemia
(Ph+ CML):

  • Who are newly diagnosed. The approval of BOSULIF in these patients was based on molecular and cytogenetic response rates. There is an ongoing clinical study to confirm clinical benefit
  • Who no longer benefit from or did not tolerate other treatment

Pfizer Oncology