Patient Enrollment Process
After the patient has been prescribed XOSPATA® (gilteritinib), enroll the patient in XOSPATA Support Solutions® one of the following four ways:
- Enroll via eRx
- Submit a prescription for XOSPATA via eRx and select as the pharmacy of choice:
- ASPN Pharmacies, LLC, Florham Park, NJ 07932
- NPI: 1538590690
- Patients will automatically be enrolled in XOSPATA Support Solutions
- Submit a prescription for XOSPATA via eRx and select as the pharmacy of choice:
- Enroll by Phone
- Contact XOSPATA Support Solutions to submit a XOSPATA prescription over the phone
- Call 1‑844‑632‑9272, Monday–Friday, 8:30 am–8:00 pm ET
- Patients will automatically be enrolled in XOSPATA Support Solutions
- Enroll via Prescriber Portala
- Log in to the XOSPATA Prescriber Portal to enroll the patient
- Enroll by Fax
- Complete the Patient Enrollment Form, including all healthcare provider and patient signatures, and fax it to 1‑844‑730‑8816
XOSPATA Support Solutions is a component of Astellas Pharma Support SolutionsSM.
aIf you do not have a Prescriber Portal account, it is easy to set one up. If you need technical assistance or help with your account, please call us at 1-844-632-9272. We are available Monday–Friday, 8:30 am–8:00 pm ET.
XOSPATA® is a registered trademark of Astellas Pharma Inc.