Patients must have commercial insurance to be eligible
Patients are not eligible if they are enrolled in a state or federally funded insurance program
Eligible, commercially insured patients may pay as little as $0 for PANZYGA and may receive a maximum benefit of $12,500 per year or the cost of patient's co-pay in a 12-month period (whichever is less) for claims received by the program. Terms and conditions/eligibility requirements apply. See full terms and conditions here.For eligible patients prescribed PANZYGA, the co-pay program is available through specialty infusion pharmacies
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 health care, 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. The value of this co-pay card is limited to a maximum of $12,500 per calendar year or the cost of patient co-pay in a 12-month period, whichever is less.
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 private 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.
Patient must be 2 years of age or older to be eligible for the co-pay benefit.
Co-pay card cannot be combined with any other savings, free trial or similar offer for the specified prescription.
Co-pay card will be accepted only at participating pharmacies.
If your pharmacy does not participate, you may be able to submit a request for a rebate in connection with this offer.
This co-pay card is not health insurance.
Offer good only in the U.S. and Puerto Rico.
Co-pay card is limited to 1 per person during this offering period and is not transferable.
A co-pay card may not be redeemed more than once per 13 days per patient.
No other purchase is necessary.
No membership fee.
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.
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INDICATIONS AND USAGE PANZYGA (Immune Globulin Intravenous [Human] - ifas) is indicated for the treatment of primary humoral immunodeficiency (PI) in patients 2 years of age and older; this includes, but is not limited to, congenital agammaglobulinemia, common variable immunodeficiency, X-linked agammaglobulinemia, Wiskott-Aldrich syndrome, and severe combined immunodeficiencies; chronic immune thrombocytopenia (cITP) in adults to raise platelet counts to control or prevent bleeding; and chronic inflammatory demyelinating polyneuropathy (CIDP) in adults to improve neuromuscular disability and impairment.
Important Safety InformationWARNING: THROMBOSIS, RENAL DYSFUNCTION, AND ACUTE RENAL FAILURE
Thrombosis may occur with immune globulin intravenous (IGIV) products, including PANZYGA. Risk factors may include: advanced age, prolonged immobilization, hypercoagulable conditions, history of venous or arterial thrombosis, use of estrogens, indwelling central vascular catheters, hyperviscosity, and cardiovascular risk factors. Thrombosis may occur in the absence of known risk factors.
Renal dysfunction, acute renal failure, osmotic nephrosis, and death may occur in predisposed patients who receive IGIV products, including PANZYGA. Patients predisposed to renal dysfunction include those with a degree of pre-existing renal insufficiency, diabetes mellitus, age greater than 65, volume depletion, sepsis, paraproteinemia, or patients receiving known nephrotoxic drugs. Renal dysfunction and acute renal failure occur more commonly in patients receiving IGIV products containing sucrose. PANZYGA does not contain sucrose.
For patients at risk of thrombosis, renal dysfunction, or acute renal failure, administer PANZYGA at the minimum dose and infusion rate practicable. Ensure adequate hydration in patients before administration. Monitor for signs and symptoms of thrombosis and assess blood viscosity in patients at risk for hyperviscosity. [see Full Prescribing Information, Warnings and Precautions (5.2, 5.4)]
Contraindications PANZYGA is contraindicated in patients who have a history of severe systemic hypersensitivity reactions, such as anaphylaxis, to human immunoglobulin and in IgA-deficient patients with antibodies against IgA and history of hypersensitivity.Warnings and Precautions Monitor renal function, including blood urea nitrogen and serum creatinine, and urine output in patients at risk of developing acute renal failure. Hyperproteinemia, increased serum osmolarity, and hyponatremia may occur in patients receiving PANZYGA. Aseptic meningitis syndrome may occur in patients receiving PANZYGA, especially with high doses or rapid infusion. Hemolysis that is either intravascular or due to enhanced red blood cell sequestration can develop subsequent to PANZYGA treatments. Risk factors for hemolysis include high doses and non-O-blood group. Closely monitor patients for hemolysis and hemolytic anemia. Monitor patients for pulmonary adverse reactions (transfusion-related acute lung injury [TRALI]). Monitor blood pressure prior to, during, and following PANZYGA infusion. Carefully consider the relative risks and benefits before prescribing the high dose regimen (for cITP) in patients at increased risk of volume overload. PANZYGA is made from human plasma and may contain infectious agents, e.g. viruses and theoretically, the Creutzfeldt-Jakob disease agent. Adverse Reactions PI – The most common adverse reactions (>5% study subjects) were headache, nausea, fever, fatigue, and abdominal pain. cITP in adults – The most common adverse reactions (>5% study subjects) were headache, fever, nausea, vomiting, dizziness, and anemia. CIDP in adults – The most common adverse reactions (>5% study subjects) were headache, fever, dermatitis, and blood pressure increase. The risk information provided here is not comprehensive; see full Prescribing Information and Boxed Warning for PANZYGA. You are encouraged to report adverse events related to Pfizer products by calling 1-800-438-1985 (US only). If you prefer, you may contact the US Food and Drug Administration (FDA) directly. Visit www.fda.gov/MedWatch or call 1-800-FDA-1088. PANZYGA® is a registered trademark of Octapharma AG. Please click here for Full Prescribing Information, including BOXED WARNING.INDICATIONS AND USAGEPANZYGA (Immune Globulin Intravenous [Human] - ifas) is indicated for the treatment of primary humoral immunodeficiency (PI) in patients 2 years of age and older; this includes, but is not limited to, congenital agammaglobulinemia, common variable immunodeficiency, X-linked agammaglobulinemia, Wiskott-Aldrich syndrome, and severe combined immunodeficiencies; chronic immune thrombocytopenia (cITP) in adults to raise platelet counts to control or prevent bleeding; and chronic inflammatory demyelinating polyneuropathy (CIDP) in adults to improve neuromuscular disability and impairment.