Care Champion Support

FOR LIVE SUPPORT, CALL 1-877-744-5675

Patient Prescribing Information
Full Prescribing Information
Indication

LORBRENA^® (lorlatinib) is a prescription medicine that is used to treat adults with non-small cell lung cancer (NSCLC) that is caused by an abnormal anaplastic lymphoma kinase (ALK) gene and that has spread to other parts of your body.

Your healthcare provider will perform a test to make sure that LORBRENA is right for you.

It is not known if LORBRENA is safe and effective in children.
Important Safety Information
For Healthcare Professionals

FINANCIAL ASSISTANCE

Pfizer Oncology Together can help you understand your insurance and identify what financial support may be available for your prescribed LORBRENA. In addition, we can help find a specialty pharmacy that can fill your prescription.

COMMERCIALLY INSURED

Resources for eligible patients with commercial, private, employer, or state health insurance marketplace coverage:

Co-pay assistance

Eligible, commercially insured patients may pay as little as $0 per month for LORBRENA. Limits, terms, and conditions apply.* There are no income requirements, forms, or faxing to enroll.

Pay as little as $0 for LORBRENA (lorlatinib) with the Co-Pay Savings Card

SIGN UP

*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. Patients may receive up to $25,000 per product in savings annually. The offer will be accepted only at participating pharmacies. This offer is not health insurance. No membership fees apply. Pfizer reserves the right to rescind, revoke, or amend this offer without notice. For full Terms and Conditions, please see PfizerOncologyTogether.com/terms. For any questions, please call 1-877-744-5675, visit PfizerOncologyTogether.com/terms or write: Pfizer Oncology Together Co-Pay Savings Program, 2250 Perimeter Park Drive, Suite 300, Morrisville, NC 27560.

MEDICARE/GOVERNMENT INSURED

Help identifying resources for eligible patients with Medicare/Medicare Part D, Medicaid, and other government insurance plans:

	Assistance with searching for financial support that may be available from independent charitable foundations. These foundations exist independently of Pfizer and have their own eligibility criteria and application processes. Availability of support from the foundations is determined solely by the foundations
	Financial assistance through Extra Help, a Medicare Part D Low-Income Subsidy (LIS) program
	Free medicine^†

^†If support from independent charitable foundations or Medicare Extra Help is not available, Pfizer Oncology Together will provide eligible patients with medication for free through the Pfizer Patient Assistance Program. The Pfizer Patient Assistance Program is a joint program of Pfizer Inc. and the Pfizer Patient Assistance Foundation^™. The Pfizer Patient Assistance Foundation is a separate legal entity from Pfizer Inc., with distinct legal restrictions.

UNINSURED

Help identifying resources for eligible patients without any form of healthcare coverage:

	Help finding coverage
	Free medicine through the Pfizer Patient Assistance Program^‡, or at a savings through the Pfizer Savings Program^§

^‡If support from independent charitable foundations or Medicare Extra Help is not available, Pfizer Oncology Together will provide eligible patients with medication for free through the Pfizer Patient Assistance Program. The Pfizer Patient Assistance Program is a joint program of Pfizer Inc. and the Pfizer Patient Assistance Foundation^™. The Pfizer Patient Assistance Foundation is a separate legal entity from Pfizer Inc. with distinct legal restrictions.

^§The Pfizer Savings Program is not health insurance. For more information, call the toll-free number: 1-877-744-5675.
There are no membership fees to participate in this program. Estimated savings are 50% and depend on such factors as the particular drug purchased, amount purchased, and the pharmacy where purchased.

At Pfizer Oncology Together, we treat your individual needs as a priority. We’ll help you identify financial assistance options so you can get your prescribed LORBRENA. We can also connect you with a dedicated Care Champion who has social work experience and will offer resources that may help with some of your day-to-day challenges. Because when it comes to support, we're in this together.^||

Emotional Support

We can connect you to diagnosis-specific support groups, an independent organization that offers short-term counseling, and a free app, developed by Pfizer Oncology, to help patients connect with loved ones and ask for the support they need.

Practical Support

Receive information to help you prepare for leaving or returning to work after being diagnosed.

And if you’re leaving work for a period of time during treatment, or preparing to return to work, we can send you information to help make the transition easier.

Educational Support

To help support your overall health and well-being, we’ve created resources about physical and mental health, as well as nutrition tips and healthy recipes developed in partnership with dietitians who specialize in oncology nutrition. We can also provide you with information to help you understand your prescribed LORBRENA.

^||Some services are provided through third-party organizations that operate independently and are not controlled by Pfizer. Availability of services and eligibility requirements are determined solely by these organizations.

USEFUL LINKS

If you’re looking to find the latest cancer research or helpful support communities, here are some third-party resources to check out.

INFORMATION ABOUT LUNG CANCER

ALK Positive

www.alkpositive.org/

ALK Positive is a worldwide community of patients, caregivers, and supporters that provides information, empathy, support, and research for those affected by ALK-positive lung cancer.

American Cancer Society

www.cancer.org

The American Cancer Society funds and conducts research, shares expert information, and provides support for patients and their loved ones who have been affected by cancer.

Lung Cancer Research Foundation

www.lungcancerresearchfoundation.org

Lung Cancer Research Foundation focuses on lung cancer awareness and educational programs and funds research for the prevention, diagnosis, treatment, and cure of lung cancer.

LUNGevity.org

www.lungevity.org

LUNGevity Foundation is committed to making an immediate impact on increasing quality of life and survivorship of people with lung cancer, as well as providing community, support, and education for all those affected by the disease.

GO2 Foundation for Lung Cancer

www.go2foundation.org

Two organizations serving the lung cancer community, the Bonnie J. Addario Lung Cancer Foundation (ALCF) and the Lung Cancer Alliance (LCA), have proudly joined forces as GO2 Foundation for Lung Cancer. They serve and advocate for the needs of those impacted by or impacting the disease.

Lung Cancer Foundation of America

www.lcfamerica.org

Two organizations serving the lung cancer community, the Bonnie J. Addario Lung Cancer Foundation (ALCF) and the Lung Cancer Alliance (LCA), have proudly joined forces as GO2 Foundation for Lung Cancer. They serve and advocate for the needs of those impacted by or impacting the disease.

LungCancer.org

www.lungcancer.org

Lungcancer.org was founded by CancerCare to be a source of support and information for lung cancer patients and their loved ones.

It's also a good idea to check with your hospital or cancer care team for information about support groups near you.

Third-party websites are neither owned nor controlled by Pfizer. Pfizer does not endorse and is not responsible for the content or services of these sites.

REGISTER FOR LORBRENA SUPPORT

Use this form to register for additional resources and support, including the Pfizer Oncology Together Co-Pay Savings Card^¶ and LORBRENA Patient Starter Kit.

Please complete errors below in red to register

All fields are required except where marked optional.

By filling out this form, you acknowledge you are over 18 years of age.

We are committed to providing support and resources designed for LORBRENA® patients and their support team. Choose the support you’d like to receive by completing the form below.

Please complete errors below in red to register

All fields are required except where marked optional.

By filling out this form, you acknowledge you are over 18 years of age.

I am a

Patient taking LORBRENA

Caregiver of a patient taking LORBRENA

Please choose one.

Please tell us the support you’d like to register for.

(select all that apply)

$0 Co-Pay Savings Card

LORBRENA Patient Starter Kit via Mail

Additional Support & Resources via Email

Please select checkbox.

Email Address

First Name

Last Name

Address

Address 2 (Optional)

City

Select State

ZIP Code

Please verify the following information to receive a $0 Co-Pay Savings Card^¶

I currently live in the United States or Puerto Rico.
I do not have insurance from any federal healthcare program (including Medicare, Medicaid, TRICARE, or any other state or federal medical pharmaceutical benefit program or pharmaceutical assistance program).
I am not over 65 years of age and retired, and if applicable, neither is my partner.
I do not receive Social Security Disability or any other Social Security Administration benefit.
I do not have end stage renal disease.
I am not active duty military, and if applicable, neither is a family member.
I agree with the Terms and Conditions

I meet the defined requirements.

Please make a selection.

Privacy Statement

Pfizer understands your personal and health information are private. The information you provide will only be used by Pfizer and parties acting on its behalf to send you materials and other helpful information and updates on LORBRENA, as well as related treatments, products, offers, and services.

By checking this box, I also agree to receive communications from Pfizer Oncology Together, a support program that offers financial assistance and personalized resources for patients prescribed Pfizer Oncology medicines.

^¶Pfizer Oncology Together Co-Pay Savings Program

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.
With this card, eligible patients will pay a $0 co-pay per eligible monthly prescription, subject to a maximum amount of $25,000 per product per calendar year. The amount of any benefit is the difference between your co-pay and $0. After the annual maximum of $25,000 per product is reached, you will be responsible for the remaining monthly out-of-pocket costs. This card may not be redeemed more than once per 30 days.
You must deduct the value of this co-pay card from any reimbursement request submitted to your 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.
This co-pay card is not valid where prohibited by law.
Card cannot be combined with any other savings, free trial, or similar offer for the specified prescription.
Card will be accepted only at participating pharmacies.
This card is not health insurance.
Offer good only in the U.S. and Puerto Rico.
Card is limited to 1 per person during this offering period and is not transferable.
No other purchase is necessary.
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 12/31/2022.
If your pharmacy does not participate, you may be able to submit a request for a rebate in connection with this offer. Mail a copy of the patient’s pharmacy receipt indicating patient name, name of medication purchased, price paid, and date purchased, along with a copy of the patient’s Pfizer Oncology Together Co-Pay Savings Card, to:

Pfizer Oncology Together Co-Pay Savings Program

2250 Perimeter Park Drive, Suite 300
Morrisville, NC 27560

Important Safety Information and Indications

Important Safety Information

LORBRENA^® (lorlatinib) may cause serious side effects, including:

Liver problems due to interactions with other medicines. It is important to know what medicines should not be taken with LORBRENA.
Central nervous system (CNS) effects. LORBRENA may cause CNS effects, including problems with thinking (such as forgetfulness or confusion), changes in mood (such as depression and thoughts about suicide or dying), psychotic effects such as seeing or hearing things that are not real (hallucinations), seizures, changes in speech and changes in sleep. Tell your healthcare provider if you experience new or worsening symptoms of CNS effects.
Increases in the cholesterol and triglycerides (lipid) levels in your blood. Most people will have an increase in the lipid levels in their blood during treatment with LORBRENA.
- If you have increases in the lipid levels in your blood during treatment with LORBRENA, your healthcare provider may need to start you on a medicine to lower the levels. If you are already taking a medicine to lower the lipid levels in your blood, your healthcare provider may need to increase your dose of that medicine.
- Your healthcare provider should do blood tests to check the lipid levels in your blood before starting treatment, 1 to 2 months after starting treatment, and during treatment with LORBRENA.
Heart problems. LORBRENA may cause very slow or abnormal heartbeats. Your healthcare provider should check your heart rhythm (electrocardiogram or EKG) before starting and during treatment with LORBRENA. Tell your healthcare provider right away if you feel dizzy or faint or have abnormal heartbeats. In some people, these problems are severe, and your healthcare provider may need to have you stop taking LORBRENA or have a pacemaker placed.
Lung problems. LORBRENA may cause severe or life-threatening swelling (inflammation) of the lungs during treatment that can lead to death. Symptoms may be similar to those from lung cancer. Tell your healthcare provider right away if you have any new or worsening symptoms of lung problems, including trouble breathing, shortness of breath, cough, or fever.
High blood pressure (hypertension). Your healthcare provider should check your blood pressure before starting treatment, 2 weeks after starting treatment, and then at least every month during treatment with LORBRENA. Your healthcare provider may need to start or change your blood pressure medicine if you have high blood pressure during treatment with LORBRENA. Tell your healthcare provider right away if you get signs or symptoms of high blood pressure, including headaches, dizziness, blurred vision, chest pain or shortness of breath.
High blood sugar (hyperglycemia). LORBRENA may increase your blood sugar levels. Your healthcare provider should do blood tests to check your blood sugar levels before starting and during treatment with LORBRENA. Your healthcare provider may need to start or change your blood sugar medicine to control your blood sugar levels. Tell your healthcare provider right away if you get new or worsening signs and symptoms of high blood sugar, including feeling very thirsty, needing to urinate more than usual, or feeling very hungry, sick to your stomach, weak or tired, or confused.

If you have serious side effects during treatment with LORBRENA, your healthcare provider may change your dose, stop your treatment for a period of time, or completely stop treatment with LORBRENA.

Before taking LORBRENA, tell your healthcare provider about all of your medical conditions, including if you:

have kidney problems
have had episodes of depression or seizures
have high levels of cholesterol or triglycerides in your blood
have problems with your heartbeat
have lung or breathing problems
have high blood pressure
have diabetes or high blood sugar
are pregnant or plan to become pregnant. LORBRENA can harm your unborn baby.
- Your healthcare provider will do a pregnancy test before you start treatment with LORBRENA.
- Tell your healthcare provider right away if you become pregnant or think you may be pregnant during treatment with LORBRENA.
  - Females who are able to become pregnant should use effective non-hormonal birth control during treatment with LORBRENA and for at least 6 months after the final dose of LORBRENA. Birth control pills (oral contraceptives) and other hormonal forms of birth control may not be effective if used during treatment with LORBRENA. Talk to your healthcare provider about birth control choices that are right for you during this time.
  - Males who have female partners who are able to become pregnant should use effective birth control during treatment with LORBRENA and for at least 3 months after the final dose of LORBRENA.
are breastfeeding or plan to breastfeed. It is not known if LORBRENA passes into your breast milk. Do not breastfeed during treatment with LORBRENA and for 7 days after the final dose. Talk to your healthcare provider about the best way to feed your baby during this time.

Tell your healthcare provider about all the medicines you take, including prescription medicines, over-the-counter medicines, vitamins, and herbal supplements. LORBRENA may affect the way other medicines work and other medicines may affect the way LORBRENA works, causing side effects.

Know the medicines you take. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.

Do not take LORBRENA if you take certain other medicines called strong CYP3A inducers. Ask your healthcare provider for a list of these medicines if you are not sure.

The most common side effects of LORBRENA include:

swelling in your arms, legs, hands, and feet (edema)
numbness and tingling feeling in your joints or arms and legs (peripheral neuropathy)
weight gain
problems with thinking, such as forgetfulness or confusion
tiredness (fatigue)
difficulty breathing
pain in your joints
diarrhea
changes in mood, such as depression and irritability
high cholesterol and triglyceride levels in the blood
cough

LORBRENA may cause decreased fertility in males. In males, this could affect your ability to father a child. Talk to your healthcare provider if you have concerns about fertility.

These are not all of the possible side effects of LORBRENA. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Indication

LORBRENA is a prescription medicine that is used to treat adults with non-small cell lung cancer (NSCLC) that is caused by an abnormal anaplastic lymphoma kinase (ALK) gene and that has spread to other parts of your body.

Your healthcare provider will perform a test to make sure that LORBRENA is right for you.

It is not known if LORBRENA is safe and effective in children.

Please see Full Prescribing Information and Patient Information.

Turn to Pfizer Oncology Together™ to learn about financial assistance resources and get personalized support from one of our dedicated Care Champions.

Patients should always ask their doctors for medical advice about adverse events.

You are encouraged to report an adverse event 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.

The FDA has established a reporting service known as MedWatch where healthcare professionals and consumers can report serious problems they suspect may be associated with the drugs and medical devices they prescribe, dispense, or use. Visit MedWatch or call 1-800-FDA-1088.

The product information provided in this site is intended for residents of the United States. The products discussed herein may have different product labeling in different countries.

The health information contained herein is provided for educational purposes only and is not intended to replace discussions with a healthcare provider. All decisions regarding patient care must be made with a healthcare provider, considering the unique characteristics of the patient.

Pfizer, PO Box 29387, Mission, KS 66201.
Last Updated: April 2021 PP-LOR-USA-0320

LORBRENA^® is a registered trademark of Pfizer Inc.

FINANCIAL ASSISTANCE

COMMERCIALLY INSURED

MEDICARE/GOVERNMENT INSURED

UNINSURED