XOSPATA Patient Savings Program
The XOSPATA Patient Savings Programa is for eligible patients who have commercial prescription insurance. The Program parameters are as follows:
- Patients may pay as little as $0 per prescription
- Patients will be enrolled in the Program for a 12-month period
- Patients have a maximum copay assistance limit of $7000 per calendar year
- There are no income requirements
INITIATING ENROLLMENT ON BEHALF OF YOUR PATIENTS
Healthcare providers can begin the Program enrollment process on behalf of their patients by following these steps:
Step 1: Click here to enroll
- Click on HEALTHCARE PROVIDER
- Click on ENROLL ON BEHALF OF PATIENT
- Answer the questions and hit SUBMIT
- Your patients will then need to complete the enrollment process via email
Step 2: Let your patients know they will be receiving an email
- Tell your patients to expect an email from XOSPATASavings@mckesson.com
- The email will ask them to read and attest to the Program terms and conditions
Step 3: Patients will receive additional communications
- An email will be sent to verify a patient's email address
- A final email will be sent with their XOSPATA Patient Savings Program's information and instructions for use
The verification, XOSPATA Patient Savings Program information, and next steps will be sent via email, which is why it is very important that your patients or their caregivers have access to an email address.
Healthcare providers may also inform patients that they can enroll themselves in the Program by going to www.ActivatetheCard.com/XOSPATASavings and selecting the "Patient" option.
For more information or help enrolling in the XOSPATA Patient Savings Program, please call 1-855-221-3493, Monday–Friday, 8:00 am–8:00 pm ET. Translators are available.
aBy enrolling in the XOSPATA Patient Savings Program ("Program"), patient acknowledges that they currently meet the eligibility criteria and will comply with the following terms and conditions: The Program is for eligible patients with commercial prescription insurance for XOSPATA® (gilteritinib). The Program is not valid for patients whose prescription claims are reimbursed, in whole or in part, by any state or federal government program, including, but not limited to, Medicaid, Medicare, Medigap, Department of Defense (DoD), Veterans Affairs (VA), TRICARE, Puerto Rico Government Insurance, or any state patient or pharmaceutical assistance program. Patients who move from commercial insurance to federal or state health insurance will no longer be eligible, and agree to notify the Program of any such change. Patients agree not to seek reimbursement from any health insurance or third party for all or any part of the benefit received by the patient through the Program. This offer is not conditioned on any past, present, or future purchase of XOSPATA. This offer is not transferrable and cannot be combined with any other offer, free trial, prescription savings card, or discount. This offer is not health insurance and is only valid for patients in the 50 United States, Washington DC, Puerto Rico, Guam and Virgin Islands. This offer is not valid for cash paying patients. This Program is void where prohibited by law. No membership fees. It is illegal to sell, purchase, trade, counterfeit, duplicate, or reproduce, or offer to sell, purchase, trade, counterfeit, duplicate or reproduce the card. This offer will be accepted only at participating pharmacies. Certain rules and restrictions apply. Astellas reserves the right to revoke, rescind, or amend this offer without notice.
XOSPATA® is a registered trademark of Astellas Pharma Inc.