Xeljanz Patient assistance program
Complete a free online enrollment application to find out if you’re eligible to pay only $49 per month for your Xeljanz medication with our help.Get Started Now
Secure: Your personal and medical information is safe with us
Convenient: Your medication is delivered straight to your door
Ongoing refills: Your medication is refilled automatically
NiceRx works with your healthcare provider to help you access affordable medications directly from U.S. pharmaceutical companies.
An introduction to NiceRx(01:52)
Next steps after qualifying(00:38)
Uploading documents and billing(00:50)
SSN & billing information(00:33)
Medication delivery time(00:41)
How it works
Get started by filling out the online enrollment application to find out if you are eligible.
NiceRx verifies your eligibility for medication assistance and notifies you if you are qualified. The pharmaceutical company provides your medication for free and you only pay our service fee.
You may be required to submit further information and documents required by the pharmaceutical company which can be securely uploaded online.
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.
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 Xeljanz cost savings if eligible
If you are eligible for the Xeljanz patient assistance program, the cost of your medication will be free. We only charge $49 per month for each medication, to cover our service fees. You could receive your Xeljanz prescription for just $49 a month, regardless of the retail price of your medication.
|Strength||Avg. monthly price at
a US pharmacy
|5mg 60 tablets||$4,690.00||$49.00||$4,641.00|
|10mg 60 tablets||$4,800.00||$49.00||$4,751.00|
Am I eligible for the Xeljanz patient assistance program?
We will review your application to determine whether you are eligible for the Xeljanz patient assistance program. Each program has its own eligibility criteria which is set by the pharmaceutical companies, however the factors considered by most programs are:
- 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 Xeljanz patient assistance program?
We make it as easy as possible to apply for the Xeljanz patient assistance program. The first step is to complete our enrollment application. Tell us about any medications you are taking, including Xeljanz. We will also ask for details about your healthcare provider, insurance, and your household income. This information is required by the pharmaceutical manufacturers who ship your medication.
If we determine that you may be eligible for Xeljanz assistance, we will handle the application process for you. We will work directly with your healthcare provider to prepare your application documents. Once we have received the signed application and supporting documents, we will submit them to the patient assistance program on your behalf. Our service continues once you are enrolled in the Xeljanz patient assistance program, and we will automatically request your Xeljanz medication refills for up to 1 year.
Is NiceRx a Xeljanz coupons provider?
We are a service provider that helps eligible individuals access the Xeljanz patient assistance program. That means that we do not offer printable Xeljanz manufacturer coupons, Xeljanz discounts, or free Xeljanz samples. We are not a Xeljanz coupon provider or Xeljanz discount card. Our service extends to assisting eligible individuals to access the medications they need through patient assistance programs.
Can NiceRx help me get Xeljanz if I have insurance?
We may be able to help you to access Xeljanz patient assistance in a variety of circumstances. This includes when your insurance company will not pay for your Xeljanz medication or if you have a high copay or coinsurance responsibility. We may also be able to help you if you do not have insurance. Please apply online to find out more.
How much does Xeljanz cost without insurance?
Xeljanz cost without insurance will vary depending on where you buy it. As a guide, Xeljanz oral solution (1 mg/mL) usually costs $4,350 for 240 milliliters. With NiceRx you will pay a flat monthly fee of $49, regardless of the retail price of your medication.
How much does Xeljanz cost with insurance?
The copay for Xeljanz with insurance depends on the terms of your healthcare plan. To find out how much this is, your healthcare provider or pharmacist will be able to calculate your copay with your current insurance.
What is Xeljanz?
Xeljanz is an FDA (U.S. Food and Drug Administration) approved medication manufactured by Pfizer Inc. Tofacitinib is a Janus kinase, JAK inhibitor used to treat certain types of arthritis such as psoriatic arthritis (PsA), rheumatoid arthritis, ankylosing spondylitis, polyarticular course juvenile idiopathic arthritis-pcJIA) in adults and pediatric patients who are two years of age and older who have had an inadequate response or intolerance to one or more TNF blockers.
Xeljanz is used:
- For the treatment of adult patients with moderate to severe active rheumatoid arthritis who have had an inadequate response or intolerance to methotrexate. It may be used as monotherapy or in combination with methotrexate or other nonbiologic disease-modifying antirheumatic drugs (DMARDs). The use of Xeljanz/Xeljanz XR in combination with biologic DMARDs or potent immunosuppressants such as azathioprine and cyclosporine is not recommended
- For the treatment of adult patients with active psoriatic arthritis (PsA) who have had an inadequate response or intolerance to methotrexate or other disease-modifying antirheumatic drugs (DMARDs). The use of Xeljanz/Xeljanz XR in combination with biologic DMARDs or potent immunosuppressants such as azathioprine and cyclosporine is not recommended
- For the treatment of adult patients with moderate to severe active ulcerative colitis (UC). The use of Xeljanz in combination with biological therapies for UC or with potent immunosuppressants such as azathioprine and cyclosporine is not recommended
What doses of Xeljanz are available?
Xeljanz is available in the following formulations:
- Xeljanz tablets: 5 mg, 10 mg
- Xeljanz XR (extended-release) tablets: 11 mg, 22 mg tofacitinib
- Xeljanz oral solution: 1 mg/mL
Please see the full prescribing information and medication guide for the complete boxed warning. Always speak with a healthcare professional for medical advice or about any changes to your dose so they can monitor and evaluate your condition.
Xeljanz active ingredients
Xeljanz contains tofacitinib as the active ingredient.
Xeljanz side effects
The most common side effects of Xeljanz in clinical trials compared to placebo include:
- Skin rash, shingles (herpes zoster)
- Increased blood pressure
- Fever, headache
- Nausea, vomiting, diarrhea
- Cold-like symptoms
- Upper respiratory tract infection, nasopharyngitis
- Elevated cholesterol levels
- Increased blood creatine phosphokinase
In rare instances, Xeljanz can cause more serious side effects. These can include:
- Serious infections – Xeljanz can lower the ability of your immune system to fight infections, leading to hospitalization or death, including tuberculosis and bacterial, invasive fungal, viral, and other opportunistic infections
- Lymphoma and other malignancies. Epstein Barr Virus-associated post-transplant lymphoproliferative disorder has been observed at an increased rate in renal transplant patients treated with Xeljanz and concomitant immunosuppressive medications
- Gastrointestinal perforations – use with caution in patients that may be at increased risk
- Potential changes in lymphocytes, neutrophils, hemoglobin, liver enzymes, and lipids
- Thrombosis, including pulmonary embolism, deep venous thrombosis, and arterial thrombosis
Your doctor will assess the benefits of using Xeljanz against your risk of side effects. Patients are encouraged to report negative side effects or adverse reactions of Xeljanz to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Xeljanz drug interactions
Xeljanz can interact with other medications. These include:
- Strong CP3A4 inhibitors (ketoconazole)
- Moderate CYP3A4 inhibitors coadministered with strong CYP2C19 inhibitors (fluconazole)
- Strong CYP3A4 inducers (rifampin)
- Immunosuppressive drugs (azathioprine, tacrolimus, cyclosporine)
- Live vaccines
This list is not exhaustive and other prescription drugs may interact with Xeljanz.
You should not use Xeljanz if you:
- Are allergic to the active ingredient tofacitinib
- Have had an allergic reaction to any of the other ingredients in Xeljanz
- Are pregnant or are planning to become pregnant
Talk to your doctor before using Xeljanz if you:
- Are taking any of the medications that could interact with Xeljanz
- Have a weak immune system or chronic infection
- Have any type of cancer
- Have kidney disease, have had a kidney transplant, or if you are on dialysis
- Have diverticulitis, or an ulcer in your stomach or intestines
- Have any heart problems
- Have had a heart attack, stroke, or blood clot
- Have high cholesterol
- Have ever smoked – higher risk factor of certain cancers, including lymphoma and lung cancer, especially if you are a current or past smoker
- Have liver (especially hepatitis B or C)
- Have chronic lung disease
- Have diabetes
- Are breastfeeding or are planning to breastfeed
Xeljanz is the trademark brand name for tofacitinib manufactured by Pfizer Inc. A generic version of tofacitinib is not available. Generic drugs are generally cheaper than brand-name drugs, but you can still find Xeljanz savings through NiceRx.
*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 the different programs and filling out all the required paperwork for each program. Subject to medication availability.
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.
The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.