Your guide to key resources and savings

If I have been prescribed CIBINQO, do I qualify for the Copay Savings Card?

To qualify for the Copay Savings Card, the patient or the patient’s caregiver must:

• Be 18 years of age or older, and
• Currently live in the United States or Puerto Rico

You may not qualify if:

• You have insurance from a federal healthcare program (including Medicare, Medicaid, TRICARE, or any other state or federal medical pharmaceutical benefit program or pharmaceutical assistance program)
• You, or your partner (if applicable), are over 65 years of age and retired
• You receive Social Security Disability Insurance (SSDI) or any other Social Security Administration (SSA) benefit
• You receive health insurance through the military

Please see the Terms and Conditions for more information. You can also call Pfizer Dermatology Patient Access at 1-833-956-DERM (1-833-956-3376) Monday-Friday, 8:00 _AM - 8:00 _PM ET to help determine whether you are eligible.

What should I do if my insurance coverage changes?

Health plans can change—so can your health insurance and prescription benefits. Once your new plan begins, Pfizer Dermatology Patient Access can help review your plan information, verify your coverage if needed, and assist with the prescription approval process. Give us a call at 1-833-956-DERM (1-833-956-3376) Monday-Friday, 8:00 _AM - 8:00 _PM ET.

What should I do if my insurance claim for CIBINQO is delayed or denied?

Pfizer Dermatology Patient Access may be able to help. Give us a call at 1-833-956-DERM (1-833-956-3376) Monday-Friday, 8:00 _AM - 8:00 _PM ET.

Eligible, commercially insured patients enrolled in the Interim Care program may receive CIBINQO for up to 2 years at no cost.^† See Limits, Terms, and Conditions. Call to explore your options.

^†_{Interim Care Rx is not health insurance and is available for eligible, commercially insured patients only. Offer is only available to patients who have been diagnosed with an FDA-approved indication for CIBINQO™ (abrocitinib), and who experience a delay or denial in insurance coverage during the prior authorization or appeals process. Not available to patients covered under Medicaid, Medicare or other federal or state healthcare programs. Limits, Terms, and Conditions apply.}

What should I do if I don’t have insurance?

Pfizer Dermatology Patient Access may be able to help. Give us a call at 1-833-956-DERM (1-833-956-3376) Monday-Friday, 8:00 _AM - 8:00 _PM ET, to learn more about the support programs that may be available to you.

What should I do if I need financial assistance or can’t afford to pay for CIBINQO?

Pfizer Dermatology Patient Access may be able to help. Pfizer has programs in place designed to help eligible patients afford their treatment. Keep reading for ways you may be able to save on your CIBINQO prescription.

• If you have commercial insurance, you may qualify for a Copay Savings Card. See Terms and Conditions.
• If you have government insurance and need financial assistance, we will provide you with information regarding Medicare Extra Help if you appear to be eligible. If turned down, we will evaluate you for the Pfizer Patient Assistance Program.* If you are eligible, we will provide CIBINQO at no cost to you. See Limits, Terms, and Conditions. Eligibility is not based on income.
• If you have no insurance and need financial assistance, we will provide you with information regarding Medicaid if you appear to be eligible. If turned down, we will evaluate you for the Pfizer Patient Assistance Program.* If you are eligible, we will provide CIBINQO at no cost to you. See Limits, Terms, and Conditions.

To speak with someone at Pfizer Dermatology Patient Access about your insurance coverage and medication costs for CIBINQO, call 1-833-956-DERM (1-833-956-3376) Monday-Friday, 8:00 _AM - 8:00 _PM ET.

^*_{The Pfizer Patient Assistance Program is a joint program of Pfizer Inc. and the Pfizer Patient Assistance Foundation™. Free medicines from Pfizer are provided through the Pfizer Patient Assistance Foundation. The Pfizer Patient Assistance Foundation is a separate legal entity from Pfizer Inc. with distinct legal restrictions.}

What should I do if my pharmacy does not accept the Copay Savings Card?

You can download and fill out a rebate form to request reimbursement of your out-of-pocket copay costs for CIBINQO. Rebate Terms and Conditions apply.

How much should I expect to pay for CIBINQO?

For more information about pricing, including what out-of-pocket costs may be for your CIBINQO prescription, please visit CIBINQOpricing.com.