FINANCIAL
ASSISTANCE

The cost for ORGOVYX may differ based on your patients' insurance coverage. How much patients pay depends on their coverage. We can help you find out what your patients' costs may be. Call 1-833-ORGOVYX (1-833-674-6899) to learn how to request an insurance benefit review.

For Medicare Part D PATIENTS

Once ORGOVYX is prescribed, your patients may look to you for guidance. This resource equips you with what you need to know about your patients' out-of-pocket costs.

For eligible commercially insured patients

ORGOVYX® (relugolix) Copay Assistance Program Card

Pay as little as $10
per month

As a part of the ORGOVYX Copay Assistance Program, eligible, commercially insured patients may pay as little as $10 per prescription, with a maximum savings per calendar year of $10,000. See program terms and conditions below.*

The ORGOVYX Support Program may be able to help those patients who are not eligible for an ORGOVYX Savings Card or need additional assistance. Call the ORGOVYX Support Program at 1-833-ORGOVYX (1-833-674-6899).

ORGOVYX Copay Assistance Program Terms, Conditions, and Eligibility Criteria

*Eligibility required. Commercially insured patients only. This copay program is subject to a calendar year maximum savings of $10,000. After the calendar year maximum savings is reached, patient will be responsible for the remaining out-of-pocket costs for ORGOVYX. The Copay Program is not valid for patients participating in Medicare, Medicaid, or other government healthcare programs. No membership fees. This offer is not health insurance. Available only to patients who have been diagnosed with an FDA-approved indication for ORGOVYX. Terms and conditions apply. For full program terms, conditions, and eligibility criteria please visit www.orgovyx.com/terms-and-conditions.

ORGOVYX NATIONAL COVERAGE
99% of Medicare patients are covered for ORGOVYX1†
93% of commercial patients are covered for ORGOVYX1†
 
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 August 2025. Transaction data are provided by SHS database as of August 2025.1

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