ORGOVYX
BRIDGE PROGRAM

Eligible patients who are experiencing coverage issues may receive ORGOVYX
at no cost for a limited period of time.*
ORGOVYX Bridge Program icon
The ORGOVYX
Bridge Program

The ORGOVYX Bridge Program can help commercially insured patients get access to treatment by providing ORGOVYX at no cost if they are:

  • Experiencing a lapse or delay in coverage
  • Waiting for approval from their insurance provider
Download the ORGOVYX
Support
Program Start Form

ORGOVYX BRIDGE PROGRAM: TERMS AND CONDITIONS

*The ORGOVYX Bridge Program ("Bridge Program") provides ORGOVYX at no cost for a limited period (up to 4 months) in a calendar year to eligible, commercially-insured patients, who have been prescribed ORGOVYX for an FDA-approved indication, and whose insurance coverage is delayed or who experience a temporary lapse in coverage. Prescribers must complete the Bridge Program prescription on the start form. By participating, patient acknowledges intent to pursue insurance coverage for ORGOVYX with their healthcare provider. Patients will receive their maintenance drug supply each month for up to 4 months or until they receive insurance coverage approval, whichever occurs earlier. The Bridge Program is not available 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 (DoD), Veterans Affairs (VA), TRICARE, Puerto Rico Government insurance, or any state patient or pharmaceutical assistance program. Patients must be residents of the United States or US Territories. The Bridge Program is not available to patients who are uninsured or where prohibited by law such as Massachusetts and Minnesota. Patients may be asked to reverify insurance coverage status during the course of the Bridge Program. Patients and participating prescribers agree not to seek reimbursement for all, or any part of the benefit received by the patient through this Bridge Program. No purchase necessary. The Bridge Program is not health insurance, nor is participation a guarantee of insurance coverage. Other limitations may apply. Sumitomo Pharma America reserves the right to rescind, revoke, or amend the Bridge Program and discontinue support at any time without notice.

99% of Medicare patients are covered for ORGOVYX*
94% of commercial patients are covered for ORGOVYX*
SEE FORMULARY COVERAGE
IN YOUR AREA

*This coverage information is provided for informational purposes only; individual plans vary, and this may not include all plans. Sumitomo Pharma America and Pfizer make no representation or guarantee concerning coverage or reimbursement for ORGOVYX; please check with individual payers for plan-specific coverage and reimbursement information and requirements. Nothing herein may be construed as an endorsement, approval, recommendation, representation, or warranty of any kind by any plan or insurer referenced. This information is subject to change without notice. Data on file. Formulary data are provided by MMIT, LLC, as of February, 2023. Transaction data are provided by SHS database as of January, 2023.