Astellas Patient Assistance Program

The Astellas Patient Assistance Programa (PAP) provides XOSPATA® (gilteritinib) at no cost to patients who meet the program eligibility requirements.

Eligibility Requirements

XOSPATA Support Solutions® will evaluate a patient's eligibility for the Astellas PAP.
For more information, contact us at 1-844-632-9272. We are available Monday–Friday, 8:30 am–8:00 pm ET.

The patient may be eligible for PAP if they:

  • Are uninsured or have insurance that excludes coverage for XOSPATA,a
  • Have a verifiable shipping address in the United States,
  • Have been prescribed XOSPATA for an FDA-approved indication, AND
  • Meet the program financial eligibility requirements

Application Process

Complete the PAP application, including all signatures, and either upload it through the Prescriber Portal or fax it to 1‑844‑730‑8816. If the patient is eligible for the Astellas PAP, we will notify you and the patient, and the XOSPATA prescription will be shipped directly to the patient's home.

aProgram is subject to eligibility restrictions and Program terms and conditions.

XOSPATA Support Solutions is a component of Astellas Pharma Support SolutionsSM.

XOSPATA® is a registered trademark of Astellas Pharma Inc.