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Gilotrif Patient assistance program

Is your Gilotrif medication too expensive? Start receiving your medication for only $49 per month.*

Complete a free online enrollment application to find out if you’re eligible to pay only $49 per month for your Gilotrif medication.

Get started today
  • Secure: Your personal and medical information is safe with us
  • Convenient: We manage the whole process and we’re here to assist you
  • Ongoing refills: We request your medication refills on your behalf
  • Secure: Your personal and medical information is safe with us
  • Convenient: We manage the whole process and we’re here to assist you
  • Ongoing refills: We request your medication refills on your behalf

NiceRx works with your healthcare provider to help you access affordable medications directly from U.S. pharmaceutical companies.

An introduction to NiceRx

Play video (01:52)
  • An introduction to NiceRx
  • Next steps after qualifying
  • Uploading documents and billing
  • SSN & billing information
  • Medication delivery time

How it works

  • Apply Online

    Get started by filling out the online enrollment application to find out if you are eligible.

  • Qualification

    NiceRx verifies your eligibility for medication assistance and notifies you if you are qualified.

  • Upload Documents

    You may be required to submit further information and documents required by the pharmaceutical company which can be securely uploaded online.

  • Application Created

    Your application is created and sent to your doctor for signature. At this stage, you will be billed $49 and will not be billed again until you receive your first medication delivery.

  • Receive Medication

    Your application is sent to the pharmaceutical company. You will be billed again once you receive your medication. We handle the entire ordering process including requesting ongoing refills.

Your monthly Gilotrif cost savings if eligible

With our help, you could get your Gilotrif medication for a flat fee of $49 per month. This single monthly fee will be the only cost you will need to pay. Each month, you could save:

Strength Avg. monthly price at
a US pharmacy
NiceRx monthly
Monthly savings
with NiceRx
30mg 30 tablets$9,200.00$49.00$9,151.00
40mg 30 tablets$9,760.00$49.00$9,711.00
20mg 30 tablets$9,200.00$49.00$9,151.00

Am I eligible for the Gilotrif patient assistance program?

Each patient assistance program has specific eligibility criteria for successful applicants, although most programs will likely consider the below factors. At NiceRx we review each Gilotrif assistance program application individually in line with the information provided in your enrollment application.  

  • I am a permanent, legal resident of the United States or Puerto Rico
  • I am uninsured or my insurance doesn’t cover my medication
  • I meet certain income eligibility requirements

How do I apply for the Gilotrif patient assistance program? 

We do everything to make it as easy as possible to apply for the Gilotrif patient assistance program. Just fill in our online enrollment application to start the process. You’ll need to tell us about any medications you’re taking, including Gilotrif. We also require some important information that is needed by the pharmaceutical manufacturers who supply your medication. This includes details about your healthcare provider, your insurance plan, and your household income. 

Having reviewed your enrollment application, NiceRx will determine if you may be eligible for Gilotrif assistance. We’ll handle the full enrollment process for you and will also request your Gilotrif medication refills on your behalf for up to one year.

Is NiceRx a Gilotrif coupons provider?

NiceRx is a service provider that helps eligible individuals access the Gilotrif patient assistance program. We are not a Gilotrif coupon, a Gilotrif discount card, or a Gilotrif copay card provider. 

If you’re looking for coupons for Gilotrif or cheap Gilotrif, know that you can likely save more with NiceRx. The total cost that you will be required to pay when enrolled in the Gilotrif patient assistance program will always be $49 per month, which is likely to be a more cost-effective ongoing option than printable Gilotrif manufacturer coupons, Gilotrif discounts, rebates, Gilotrif savings cards, trial offers, or free Gilotrif samples.

Can NiceRx help me get Gilotrif if I have insurance? 

At NiceRx we review every patient assistance program enrollment application individually. This means we may be able to assist in a range of situations if you have insurance. These include if:

  • You have a high copay or coinsurance responsibility for Gilotrif
  • Your insurance company won’t pay for your Gilotrif prescription

We may even be able to assist if you don’t have insurance. Begin your enrollment application online with NiceRx to find out more.

How much is Gilotrif with insurance?

If you have insurance, the cost of Gilotrif will depend on the terms of your healthcare plan. To find out exactly what you will need to pay, contact your pharmacist or insurance provider. They will be able to calculate your copay with your current insurance.

How much does Gilotrif cost without insurance?

Gilotrif prices without insurance can vary by retailer. A pack of 30 Gilotrif tablets at either 20 mg, 30 mg, or 40 mg will cost around $10,600. Please note this is just a guide price. With NiceRx you’ll always pay a flat monthly fee of $49.

What is Gilotrif?

Gilotrif is a medication prescribed to adults with a type of cancer called non-small cell lung cancer (NSCLC). It’s used when:

  • Your cancer has spread to other parts of your body (metastatic cancer)


  • Your cancerous cells have a type of mutation in a certain set of genes called epidermal growth factor receptor (EGFR) genes. This mutation must be one that doesn’t make the cancerous cells resistant to treatments like Gilotrif – you’ll be tested to see if this is the case)
  • You haven’t previously been treated for metastatic lung cancer (cancer that started in your lungs and then spread to other parts of your body)


  • You have a type of non-small cell lung cancer called squamous cell carcinoma (SqCC)
  • Your cancer has previously been treated with a chemotherapy that contains platinum

Gilotrif is a targeted therapy (rather than a traditional chemotherapy) that specifically affects your cancerous cells. It can stop them from growing and spreading, helping to slow the progression of your cancer. You take Gilotrif as a tablet that you swallow.

Gilotrif active ingredients

The active ingredient in Gilotrif is called afatinib. It helps to stop the growth and spread of cancerous cells. As Aafatinib is a targeted therapy, it is designed to specifically attack the cancerous cells that cause your NSCLC. It does this by binding to the faulty epidermal growth factor receptors that help your cancerous cells grow and multiply. This stops the receptors working, making it harder for your cancer to spread.

Gilotrif side effects & Gilotrif drug interactions

As is the case with all medications, Gilotrif can cause side effects, with the most common including:

  • Feeling sick (nausea)
  • Being sick (vomiting)
  • Diarrhea
  • Dry skin
  • Itching
  • Skin rashes
  • Acne
  • Sores in your mouth
  • Inflammation of your nails
  • A decreased appetite

Gilotrif can also cause more serious side effects, although these are rarer. When severe side effects do occur, they can include:

  • Severe allergic reactions to the medication
  • Severe diarrhea 
  • Serious skin reactions that can cause blistering and peeling
  • New or worsening heart problems 
  • Lung problems that can make it hard to breathe and that can be fatal
  • Liver problems that can reduce your liver function, cause liver failure, and that can be fatal
  • Tears (perforations) in your stomach or intestines
  • Eye problems, including swelling, redness, sensitivity to light, blurred vision and other vision defects

Gilotrif can interact with other medications, which can change how Gilotrif and the other medications work and can make some side effects more likely. These medications include:

  • Any medications you’re taking to treat a heart condition, particularly verapamil, quinidine, or amiodarone
  • Any medications that affect how your immune system works
  • Any medications you’re taking to treat fungal infections, particularly ketoconazole or itraconazole
  • Any antibiotics you’re taking to treat a bacterial infection, particularly erythromycin or rifampicin
  • Any HIV/AIDS medications, particularly ritonavir or nelfinavir
  • Any medications you’re taking to treat seizures, particularly carbamazepine, phenytoin, or phenobarbital
  • Rosuvastatin, taken to lower your cholesterol
  • Sulfasalazine, taken to treat inflammatory autoimmune conditions like rheumatoid arthritis, ulcerative colitis, and Crohn’s disease

Gilotrif warnings & precautions

Gilotrif can harm your unborn baby. If you become pregnant or think you’re pregnant, contact your doctor immediately. Women who can become pregnant should use effective birth control when taking Gilotrif, for up to two weeks after the last dose.

You should limit your time in the sun when taking Gilotrif, as it can make your skin more sensitive to sunlight. Try to avoid strong sun. Wear sunscreen, a hat, and clothes that cover your skin if you must be out in the sun.

You should not take Gilotrif if you:

  • Are allergic to the active ingredient afatinib, or are allergic to any of the other ingredients in Gilotrif 
  • Are under 18 years of age
  • Are pregnant or are planning to become pregnant

Talk to your doctor before taking Gilotrif if you:

  • Have any heart, kidney, or liver problems
  • Have lung or breathing problems other than your cancer
  • Have ever had any stomach or intestinal problems, like ulcers, tears (perforations), or diverticulitis (inflammation in your large intestine)
  • Have a history of eye problems
  • Are breastfeeding or are planning to breastfeed

*Qualifying persons may obtain medications directly from patient assistance programs without any out-of-pocket cost (or for less than $49 per medication). However, our monthly flat rate of just $49 per medication spares you the hassle of tracking down the different programs and filling out all the required paperwork for each program.

Enrollees enjoy a full-service solution, as NiceRx assists them and their physicians with the entire process. We prepare all required documents for the physician to sign, help enrollees manage all prescription refills, monitor eligibility criteria, and maintain enrollment.

**If you do not receive medications because you were determined to be ineligible for the prescription assistance by the applicable pharmaceutical companies and you have a letter of denial, we will refund any fees you paid toward medications for which you did not qualify to receive prescription assistance (“Refund”).

To receive a refund, you must send the letter of denial to us by fax to 888-517-7444, or by e-mail to [email protected] within 30 days of your receipt of such letter. The Refund is your sole and exclusive remedy for any fees you may wish to dispute.