Companies A-Z

Astellas Pharma U.S., Inc.

• For help with Xospata, call 1.844.632.9272.

• For help with Xtandi, call 1.855.898.2634.

• For help with Padcev, call 1.888.402.0627.

Oncology-related products: Padcev™ (enfortumab vedotin-ejfv) injection for intravenous use, Xospata^® (gilteritinib) tablets, Xtandi^® (enzalutamide) capsules

Patient Assistance Program

Astellas Patient Assistance Program

The Astellas Patient Assistance Program provides Xtandi or Xospata at no cost to patients who meet the program eligibility requirements. Patients may be eligible if they meet the following criteria:

• Be uninsured or have insurance that excludes coverage for Xtandi or Xospata.

• Have a verifiable shipping address in the United States.

• Have been prescribed Xtandi or Xospata for an FDA-approved indication.

• Meet program financial eligibility requirements.

To enroll a patient in the Astellas Patient Assistance Program, complete the Xtandi or Xospata Support Solutions patient enrollment process, including all signatures, and upload it through the prescriber portal or fax it to the number on the form. If the patient is eligible, the patient and provider will be notified, and the prescription will be shipped directly to the patient’s home.

For questions about this program for Xtandi, call 1.855.898.2634, Monday through Friday, 8:00 AM to 8:00 PM EST. For questions about this program for Xospata, call 1.844.632.9272, Monday through Friday, 8:30 AM to 8:00 PM EST.

Co-Pay Card/Out-Of-Pocket Cost Assistance

Padcev Co-Pay Assistance Program

The Padcev Co-Pay Assistance Program is for eligible patients who have private commercial health insurance and are not insured by any federal or state healthcare program, including, but not limited to, Medicare, Medicaid, TriCare, or Veterans Affairs. Under this program:

• Patients may pay as little as $5 per dose

• A patient will be enrolled in the program for a 12-month period

• Patients may save up to a maximum of $25,000 per calendar year

• There are no income requirements.

This offer is not valid for cash-paying patients. Padcev Support Solutions can evaluate eligibility and enroll patients in the Padcev Co-pay Assistance Program.

For more information, call 1.888.402.0627, Monday through Friday, 8:30 AM to 8:00 PM EST.

Reimbursement Assistance

Padcev Support Solutions℠

Benefits Investigation

Padcev Support Solutions offers benefits investigation assistance to evaluate a patient’s insurance coverage for Padcev. After performing a benefits verification, a summary of benefits will be provided that includes:

• The patient’s insurance coverage for Padcev

• Requirements for prior authorization or other coverage restrictions, if any

• Cost-sharing responsibilities, including the deductible, coinsurance or co-payment, and out-of-pocket maximums.

Padcev Support Solutions will initiate the benefits verification upon receipt of completed patient enrollment form. Once it is complete, a summary of benefits will be sent.

Prior Authorization

Padcev Support Solutions can provide prior authorization assistance when a patient’s insurer requires prior authorization approval. After determining that a prior authorization is required, the program will obtain the appropriate form and transfer basic patient and healthcare provider information to the required form. It will then be sent to the healthcare provider to review, complete, and sign. Padcev Support Solutions will inform the healthcare provider how and where to submit the completed form, and it will follow up with the insurer to confirm receipt, check status, and obtain a determination.

Denial Appeals

If the patient’s insurer denies a prior authorization request and the healthcare provider determines that an appeal is appropriate, Padcev Support Solutions can assist the healthcare provider with an appeal for a denied prior authorization request. The program will determine what additional documentation may be required by the patient’s insurer, inform the healthcare provider of what information is needed and where to send the appeal, and track and inform the healthcare provider of the appeal status.

For more information, visit the Padcev Support Solutions website.

Co-Pay Card/Out-Of-Pocket Cost Assistance

Xospata Patient Savings Program

The Xospata Patient Savings Program 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

• There are no income requirements.

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, Veterans Affairs, TriCare, Puerto Rico government insurance, or any state patient or pharmaceutical assistance program. This offer is not valid for cash-paying patients.

Healthcare providers can begin the enrollment process on behalf of their patients online. Providers should let patients know that they will receive an email to attest to the program's terms and conditions. Patients will then receive additional communications via email to confirm the patient's email address and instructions for use.

For more information or help with enrollment, call 1.855.221.3493, Monday through Friday, 8:00 AM to 8:00 PM EST.

Insurance Coverage-Related Delay Program

Xospata Quick Start+® Program

The Xospata Quick Start+ Program provides a one-time, seven-day supply of Xospata at no cost to eligible patients who experience an insurance-related delay. Overnight shipping is offered directly to patients. To be eligible, patients must:

• Have prescription drug insurance

• Be new to Xospata therapy

• Have been prescribed Xospata for an FDA-approved indication

• Have experienced an insurance-related access delay.

To enroll, fill out the appropriate section during the Xospata Support Solutions patient enrollment process.

For more information, call 1.844.632.9272, Monday through Friday, 8:30 AM to 8:00 PM EST.

Reimbursement Assistance

Xospata Support Solutions℠

Benefits Verification

Xospata Support Solutions offers benefits investigation assistance to evaluate a patient’s insurance coverage for Xospata. After performing a benefits verification, a summary of benefits will be provided that includes:

• The patient’s insurance coverage for Xospata

• Requirements for prior authorization, step edit, or other coverage restrictions, if any

• Cost-sharing responsibilities, including the deductible, coinsurance or co-payment, and out-of-pocket maximums

• A list of specialty pharmacies that participate in the patient's insurance plan.

Xospata Support Solutions will initiate the benefits verification upon receipt of a Xospata prescription or a completed patient enrollment form. Once it is complete, a summary of benefits will be sent.

Prior Authorization

Xospata Support Solutions can provide prior authorization assistance when a healthcare provider requests prior authorization or benefits verification assistance. After determining that a prior authorization is required, the program will obtain the appropriate prior authorization form and transfer basic patient and healthcare provider information to the required form. It will then be sent to the healthcare provider to review, complete, and sign. The healthcare provider can submit the form directly to the insurer. Xospata Support Solutions will follow up with the insurer to confirm receipt, check status, and obtain the outcome.

Denial Appeals

If the patient’s insurer denies a prior authorization request and the healthcare provider determines that an appeal is appropriate, Xospata Support Solutions can assist the healthcare provider with an appeal for a denied request. The program will determine if any additional documentation is required by the patient’s insurer, inform the healthcare provider of what information is needed and where to send the appeal, and track and inform the healthcare provider of the appeal’s status.

For more information, visit the Xospata Support Solutions website.

Co-Pay Card/Out-Of-Pocket Cost Assistance

Xtandi Patient Savings Program

The Xtandi Patient Savings Program 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

• There are no income requirements.

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, Veterans Affairs, TriCare, Puerto Rico government insurance, or any state patient or pharmaceutical assistance program.

Healthcare providers can begin the enrollment process on behalf of their patients online. Providers should let patients know they will receive an email to attest to the program's terms and conditions. Patients will then receive additional communications via email to verify the patient's email and instructions for use.

For more information or help with enrollment, call 1.855.217.8311, Monday through Friday, 8:00 AM to 8:00 PM EST.

Insurance Coverage-Related Delay Program

Xtandi Quick Start+® Program

The Xtandi Quick Start+ Program provides a one-time, 14-day supply of Xtandi at no cost to new, eligible patients who experience a delay in insurance coverage. Overnight shipping is offered directly to the patient. Patient eligibility requirements for this program include but are not limited to:

• Having a prescription drug insurance

• Being new to Xtandi therapy

• Having experienced an insurance-related access delay

• Having been prescribed Xtandi for an FDA-approved indication.

To enroll, fill out the appropriate section during the Xtandi Support Solutions patient enrollment process.

For questions, call 1.855.898.2634, Monday through Friday, 8:00 AM to 8:00 PM EST.

Reimbursement Assistance

Xtandi Support Solutions℠

Benefits Verification

Xtandi Support Solutions offers benefits investigation assistance to evaluate a patient’s insurance coverage for Xtandi. After performing a benefits verification, a summary of benefits will be provided that includes:

• The patient’s insurance coverage requirements Xtandi

• Requirements for prior authorization, step edit, or other coverage restrictions, if any

• Cost-sharing responsibility, including deductibles, coinsurance or co-payment, and out-of-pocket maximums

• A list of specialty pharmacies that participate in patient's insurance coverage.

Xtandi Support Solutions will initiate the benefits verification upon receipt of completed patient enrollment form. Once it is complete, a summary of benefits will be sent.

Prior Authorization

Xtandi Support Solutions can provide prior authorization assistance when a patient’s insurer requires prior authorization approval. Xtandi Support Solutions will communicate prior authorization requirements to the healthcare provider and send the prescription to a specialty pharmacy. It will then follow up with the specialty pharmacy to confirm receipt, check status, and notify the healthcare provider of the outcome.

Denial Appeals

If the patient’s insurer denies a prior authorization request, Xtandi Support Solutions can assist the healthcare provider with an appeal for a denied prior authorization request. The program will determine if any additional documentation is required by the patient’s insurer, inform the healthcare provider of what information is needed and how to provide it to the insurer, and track and inform the healthcare provider of the appeal status.

For more information, visit the Xtandi Support Solutions website.