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HomeAbout OCTAGAM 10%EfficacyEfficacyDMcITPSafety & TolerabilitySafety & TolerabilityDMcITPDosing & Infusion RatesDosing & Infusion Rates DMcITPSupportSupportMaterialsVideosPfizer OCTAGAM Co-Pay ProgramPfizer IGuide™Ig CompanionFrequently asked questionsRequest a representative

Coverage

Prescribing Information, including BOXED WARNINGIndicationsOCTAGAM 5%Patient Site
Coverage
Find OCTAGAM 10% coverage information in your area

*Some plans may not display due to health plan–specific policy.

The information provided is not a guarantee of coverage of payment (partial or full) and is subject to change without notice.

Access and enrollment based on MMIT formulary information as of [EFFECTIVE_DATE] and represents the local area, based on the first three digits of the ZIP code.
Access based on MMIT formulary information as of [EFFECTIVE_DATE].

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TERMS AND CONDITIONS
By using this co-pay card, you acknowledge that you currently meet the eligibility criteria and will comply with the terms and conditions described below:

  • Patients are not eligible to use this card if they are enrolled in a state or federally funded insurance program, including but not limited to Medicare, Medicaid, TRICARE, Veterans Affairs health care, a state prescription drug assistance program, or the Government Health Insurance Plan available in Puerto Rico (formerly known as “La Reforma de Salud”).
  • Patient must have private insurance. Offer is not valid for cash paying patients. The value of this co-pay card is limited to a maximum of $12,500 per calendar year or the cost of patient co-pay in a 12-month period, whichever is less.
  • This co-pay card is not valid when the entire cost of your prescription drug is eligible to be reimbursed by your private insurance plan or other private health or pharmacy benefit programs.
  • You must deduct the value of this co-pay card from any reimbursement request submitted to your private insurance plan, either directly by you or on your behalf.
  • You are responsible for reporting use of the co-pay card to any private insurer, health plan, or other third party who pays for or reimburses any part of the prescription filled using the co-pay card, as may be required. You should not use the co-pay card if your insurer or health plan prohibits use of manufacturer co-pay cards.
  • Patient must be 18 years of age or older to be eligible for the co-pay benefit for Octagam 10% and 2 years of age or older to be eligible for the co-benefit for Octagam 5%.
  • This co-pay card is not valid where prohibited by law.
  • The benefit under the co-pay card program is offered to, and intended for the sole benefit of, eligible patients and may not be transferred to or utilized for the benefit of third parties, including, without limitation, third party payers, pharmacy benefit managers, or the agents of either.
  • Co-pay card cannot be combined with any other external savings, free trial or similar offer for the specified prescription (including any program offered by a third party payer or pharmacy benefit manager, or an agent of either, that adjusts patient cost-sharing obligations, through arrangements that may be referred to as “accumulator” or “maximizer” programs).
  • Third party payers, pharmacy benefit managers, or the agents of either, are prohibited from assisting patients with enrolling in the [coupon/co-pay card] program.
  • Co-pay card will be accepted only at participating pharmacies.
  • If your pharmacy does not participate, you may be able to submit a request for a rebate in connection with this offer.
  • This co-pay card is not health insurance.
  • Offer good only in the U.S. and Puerto Rico.
  • Co-pay card is limited to 1 per person during this offering period and is not transferable.
  • A co-pay card may not be redeemed more than once per 30 days per patient.
  • No other purchase is necessary.
  • No membership fee.
  • Data related to your redemption of the co-pay card may be collected, analyzed, and shared with Pfizer for market research and other purposes related to assessing Pfizer’s programs. Data shared with Pfizer will be aggregated and de-identified; it will be combined with data related to other co-pay card redemptions and will not identify you.
  • Pfizer reserves the right to rescind, revoke or amend this offer without notice.
  • Offer expires 12/31/2024.
For more information, call 1-866-642-7606, visit https://octagam-10.pfizerpro.com/support/octagam-co-payprogram, or write:

Octagam Co-Pay Program
P.O. Box 6875
Bridgewater, NJ 08807
PA=Prior Authorization; ST=Step Therapy.


Formulary data provided by Managed Markets Insight & Technology, LLC, (MMIT) are updated monthly and current as of 11/2024. The information provided is not a guarantee of coverage or payment (partial or full) and is subject to change without notice. Please confirm coverage with each patient’s plan. Formulary status does not imply safety or efficacy of any product.
 Savings for eligible patients

Co-pay assistance may be available*

*Terms and Conditions apply, see below.

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To report an adverse event, please call 1-800-438-1985

Pfizer for Professionals 1-800-505-4426

This site is intended only for U.S. healthcare professionals. The products discussed in this site may have different product labeling in different countries. The information provided is for educational purposes only.

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Indications and Usage

OCTAGAM® 10% [Immune Globulin Intravenous (Human)] liquid is indicated for the treatment of chronic immune thrombocytopenic purpura (cITP) to rapidly raise platelet counts to control or prevent bleeding in adults and for dermatomyositis (DM) in adults.

Please click here for Full Prescribing Information, including BOXED WARNING.

Indications and Usage OCTAGAM® 10% [Immune Globulin Intravenous (Human)] liquid is indicated for the treatment of chronic immune thrombocytopenic purpura (cITP) to rapidly raise platelet counts to control or prevent bleeding in adults and for dermatomyositis (DM) in adults. Please click here for Full Prescribing Information, including BOXED WARNING.
IMPORTANT SAFETY
INFORMATION WARNING: THROMBOSIS, RENAL DYSFUNCTION, AND ACUTE RENAL FAILURE
  • Thrombosis may occur with immune globulin intravenous (IgIV) products, including OCTAGAM 10% liquid. Risk factors may include: advanced age, prolonged immobilization, hypercoagulable conditions, history of venous or arterial thrombosis, use of estrogens, indwelling central vascular catheters, hyperviscosity, and cardiovascular risk factors. Thrombosis may occur in the absence of known risk factors.
  • Renal dysfunction, acute renal failure, osmotic nephrosis, and death may occur in predisposed patients who receive IgIV products, including OCTAGAM 10% liquid. Patients predisposed to renal dysfunction include those with a degree of pre-existing renal insufficiency, diabetes mellitus, age greater than 65, volume depletion, sepsis, paraproteinemia, or patients receiving known nephrotoxic drugs. Renal dysfunction and acute renal failure occur more commonly in patients receiving IgIV products containing sucrose. OCTAGAM 10% liquid does not contain sucrose.
  • For patients at risk of thrombosis, renal dysfunction, or acute renal failure, administer OCTAGAM 10% liquid at the minimum dose and infusion rate practicable. Ensure adequate hydration in patients before administration. Monitor for signs and symptoms of thrombosis and assess blood viscosity in patients at risk for hyperviscosity.
Dosing and Administration Patients with dermatomyositis are at increased risk for thromboembolic events; monitor carefully and do not exceed an infusion rate of 0.04 mL/kg/min. ContraindicationsOCTAGAM 10% liquid is contraindicated in patients who have a history of severe systemic hypersensitivity reactions, such as anaphylaxis, to human immunoglobulin and in IgA-deficient patients with antibodies against IgA and history of hypersensitivity.Warnings and PrecautionsOCTAGAM 10% liquid may cause hypersensitivity in patients with a corn allergy. OCTAGAM 10% liquid contains maltose, which is derived from corn. Monitor renal function, including blood urea nitrogen and serum creatinine, and urine output in patients at risk of developing acute renal failure. Falsely elevated blood glucose readings may occur during and after the infusion of OCTAGAM 10% liquid with testing by some glucometers and test strip systems. Hyperproteinemia, increased serum osmolarity, and hyponatremia may occur in patients receiving OCTAGAM 10% liquid. Hemolysis that is either intravascular or due to enhanced red blood cell sequestration can develop subsequent to treatment with OCTAGAM 10% liquid. Risk factors for hemolysis include high doses and non–O-blood group. Closely monitor patients for hemolysis and hemolytic anemia. Aseptic meningitis syndrome may occur in patients receiving OCTAGAM 10% liquid, especially with high doses or rapid infusion. Monitor patients for pulmonary adverse reactions (transfusion-related acute lung injury [TRALI]). OCTAGAM 10% liquid is made from human plasma and may contain infectious agents, eg, viruses and, theoretically, the Creutzfeldt-Jakob disease agent. Adverse Reactions cITP - The most common adverse reactions reported in >5% of study subjects were headache, fever, and increased heart rate. DM - The most common adverse reactions reported in >5% of study subjects were headache, fever, nausea, vomiting, increased blood pressure, chills, musculoskeletal pain, increased heart rate, dyspnea, and infusion site reactions.You are encouraged to report adverse events related to Pfizer products by calling 1-800-438-1985 (US only). If you prefer, you may contact the US Food and Drug Administration (FDA) directly. Visit www.fda.gov/MedWatch or call 1-800-FDA-1088.OCTAGAM® is a registered trademark of Octapharma AG.Please click here for Full Prescribing Information, including BOXED WARNING.INDICATIONS AND USAGEOCTAGAM® 10% [Immune Globulin Intravenous (Human)] liquid is indicated for the treatment of chronic immune thrombocytopenic purpura (cITP) to rapidly raise platelet counts to control or prevent bleeding in adults and for dermatomyositis (DM) in adults.