This site is intended only for healthcare professionals of the United States and Puerto Rico.
DIANA
Part of YourSource care team
To learn more, call (833) 428-4968
OPTION 1 TO SPEAK WITH A REPRESENTATIVE | M-F, 8am-8pm ET
Meet the dedicated YourSource Care Team.
Do your patients need assistance with getting their Oxbryta prescription filled? Direct them to sign up for a call with one of our ARMs.
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Listen to a member of our Nurse Support Team discuss what it means to provide patients like yours with support from YourSource.
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Your guide to helping your patients start and continue treatment as prescribed.
Enroll your patients in YourSource either using the Prescription/Enrollment Form, or through the YourSource HCP Portal.
Each insurer has their own Prior Authorization process, and timelines may differ; however, many patients receive approval within 2-4 days for Oxbryta prescriptions.
Contact YourSource at (833) 428-4968, M-F, 8am-8pm ET, with general questions regarding the Prior Authorization process.
YourSource provides a Sample Appeal Template and a Sample Letter of Medical Necessity Template. If you have general questions while completing the templates, reach out to a YourSource Care Coordinator at (833) 428-4968, M-F, 8am-8pm ET.
YourSource Access Navigators are here to help. If you are unsure who your Access Navigator is, contact YourSource at (833) 428-4968, M-F, 8am-8pm ET.
Let's work together to help your patients receive additional treatment support. Get started by completing all Prescriber pages of the YourSource Enrollment Formd and have your patient (or Authorized Caregiver) complete and sign the Patient Authorization and Consent Form.
MARKUS
Family man, entertainer, sports enthusiast, and enrolled YourSource member
The HCP Portal is a resource to enroll patients in YourSource. Visit YourSourcePortal.com to get started.
Download the Prescription/Enrollment Form. Fax the completed Form to (888) 418-4178.
Once you’ve talked to your patient about enrolling in YourSource:
eProcess is subject to variability per patient's coverage type.
Click/tap on the cards below to reveal more information about each step.
If your patient’s coverage for Oxbryta is denied, Care Coordinators can provide information about the appeals process. You can submit an Appeal and a Letter of Medical Necessity on behalf of your patient. If your patient is eligible and approved for the Pfizer Patient Assistance Program (PAP), your patient will receive approval for free product.
Sample Appeal Template
Sample Letter of Medical Necessity
To learn more, call (833) 428-4968
OPTION 1 TO SPEAK WITH A REPRESENTATIVE | M-F, 8am-8pm ET
Contact a Care Coordinator if you have questions when completing these templates.
We know at times patients may worry about paying for treatment. YourSource will work with your patients and their Authorized Caregivers to help explain their insurance benefits and determine which financial assistance options they may qualify for.
If your patient has commercial, private, employer, or state health insurance marketplace coverage, they could pay as little as $0 per month for Oxbryta, with a maximum benefit of $15,000 per calendar year.f
The YourSource Commercial Copay Program provides financial assistance with out-of-pocket deductibles, copay, or coinsurance costs for eligible patients.f,g
Maya represents an eligible patient who is covered under her parents’ commercial insurance, with a copay of $80. Like more than 90% of commercially insured patients who use YourSource Commercial Copay Program, her parents pay $0 for her Oxbryta treatment.f,g,h
If your patient does not have health insurance, YourSource may be able to help them find programs that provide assistance. We’ll check to see if your patient is eligible for a government program that can help pay for prescription medicines through Medicaid. If your patient appears to be eligible, we’ll guide them on how to apply. We’ll see if they're eligible to receive up to a 90-day supply of Oxbryta for free while applying for Medicaid.
If they do not qualify for Medicaid, they may be able to receive their medication for free for up to 1 year through the Pfizer Patient Assistance Program (PAP).f,i
Joshua is an example of an eligible patient who is uninsured. He applied to and was approved for the Pfizer PAP for eligible patients and receives his Oxbryta treatment for free.f,i
If your patient has Medicare/Medicare Part D, Medicaid, TRICARE, or another government insurance plan, YourSource may be able to help identify financial support resources. We can assist them with searching for financial support from alternate funding resources, which may include financial assistance through Extra Help, a Medicare Part D Low-Income Subsidy (LIS) program. If support from alternate funding resources or Medicare Extra Help is not available, we’ll see if your patient is eligible for the Pfizer Patient Assistance Program (PAP) for Free Drug.f,g,i
Kevin represents an eligible patient who has a government-funded insurance plan. He applied to and was approved for the Pfizer PAP for eligible patients and receives his Oxbryta treatment for free.f,g,i
Hear how our financial assistance has helped Markus, a real patient, continue his Oxbryta treatment as prescribed by his healthcare provider.
Watch now
RESOURCES
Use the resources below to learn more about the support services and coverage options YourSource can provide for your patients.
Complete the enrollment process virtually using the YourSource HCP Portal at YourSourcePortal.com.
Enroll patients in YourSource by downloading, printing, completing, and faxing the Prescription/Enrollment Form.
Your guide to helping your patients start and continue treatment as prescribed.
Submit if your patient’s Oxbryta coverage is denied.
Submit if your patient requires treatment with Oxbryta.
Watch videos from a member of our Nurse Support Team and enrolled patients about how YourSource can provide assistance.
Watch now:
Your patient’s guide to Oxbryta access support and getting started with YourSource
This convenient Wallet Card provides patients with important YourSource and Specialty Pharmacy phone numbers.
If your patient needs assistance with filling their Oxbryta prescription, an Access & Reimbursement Manager (ARM) can help. Tell them to sign up for a call today!
Use our Locator Tool to connect your patients with community-based and national organizations that may offer additional support in their area.j
jThese resources are meant to be informational only and are not intended to replace medical advice.
If you have additional questions or want more information about Oxbryta, explore the website.
MARKUS
Family man, entertainer, sports enthusiast, and enrolled YourSource member
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