Litfulo (ritlecitinib)

Do You Qualify?

Income Limits (400% FPL)

Income threshold calculated at 400% of FPL per standard Pfizer RxPathways guidelines for specialty medications.

Based on 2025 HHS Federal Poverty Level guidelines.

# Pfizer Dermatology Patient Access Program for Litfulo (Ritlecitinib): A Complete Patient Guide

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Who Qualifies for the Pfizer Dermatology Patient Access?

If you have been prescribed Litfulo (ritlecitinib) for severe alopecia areata and cannot afford it, you may qualify to receive it at little or no cost through the Pfizer Dermatology Patient Access program. For a single-person household, the maximum annual income limit is $60,240. Larger households may qualify at higher income levels.

The program is open to patients who are uninsured, underinsured, or have commercial (private) insurance — including those facing coverage delays or denials through an Interim Care Rx benefit. Note that residents of Massachusetts and Michigan are currently excluded from the commercial insurance pathway. Medicaid beneficiaries are generally not eligible. If you meet the income and insurance requirements, this program may cover your Litfulo at no charge.

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About Litfulo (Ritlecitinib)

Litfulo (ritlecitinib) is a prescription oral medication approved by the U.S. Food and Drug Administration (FDA) to treat severe alopecia areata in adults and adolescents 12 years and older. It belongs to a drug class called JAK3/TEC kinase inhibitors, which work by targeting specific enzymes involved in immune system activity.

Litfulo is a specialty medication, and without insurance or assistance, its list price can reach thousands of dollars per month — placing it out of reach for many patients. There are currently no FDA-approved generic or biosimilar versions of ritlecitinib available, which means the brand-name product is the only option and patient assistance programs are especially important for those who cannot afford it.

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Income Eligibility: Full Breakdown

The Pfizer Dermatology Patient Access program uses income thresholds set at approximately 400% of the Federal Poverty Level (FPL). Your eligibility is based on your total household income and the number of people in your household. The current limits are:

| Household Size | Max Annual Income |

|---|---|

| 1 person | $60,240 |

| 2 persons | $81,760 |

| 3 persons | $103,280 |

| 4 persons | $124,800 |

Income is typically verified using your most recent federal tax return, a W-2 form, or three months of recent pay stubs. If your income has changed significantly since last year — for example, due to job loss or reduced hours — you may be able to use current pay stubs rather than last year's tax return to better reflect your situation.

If your income is above these limits, you may not qualify for free medication through this program, but you may still have options. See the "Alternatives If You Don't Qualify" section below for other resources, including a manufacturer savings card for insured patients.

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Insurance Requirements Explained

Your insurance situation determines how the program applies to you:

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Step-by-Step: How to Apply

Step 1: Gather your documents.

Before starting, collect the following: a valid Litfulo prescription from your prescriber, proof of income (most recent tax return, W-2, or three months of pay stubs), and a completed enrollment form.

Step 2: Download or request the enrollment form.

Visit the program's official application page at https://www.litfulo.com/pfizer-dermatology-patient-access to access the enrollment form. You can also call (833) 956-3376 to request one by phone.

Step 3: Choose your application method.

You have multiple ways to apply:

Step 4: Have your prescriber sign off.

Your prescriber will need to confirm your prescription and may need to sign part of the enrollment form. Coordinate with their office before submitting.

Step 5: Submit and follow up.

After submission, processing typically takes 2 to 3 business days. Keep a copy of everything you submit. If you do not hear back within that window, follow up by calling the program at (833) 956-3376.

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What to Expect: Timeline and Delivery

Once your application is approved, you can expect a response within 2 to 3 business days. Pfizer or the program administrator will notify you (and typically your prescriber) of the decision. If approved, Litfulo will be shipped directly to your home address — you do not need to pick it up at a pharmacy or prescriber's office.

You will not need to do anything at pickup since delivery comes to you. However, make sure someone is available to receive the shipment, as specialty medications may require a signature.

This program requires annual reauthorization. Before your approval period ends — usually around the 12-month mark — you will need to resubmit updated income documentation and a renewed prescription to continue receiving your medication without interruption.

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Alternatives If You Don't Qualify

If you do not meet the eligibility requirements for the Pfizer Dermatology Patient Access program, consider these options:

1. Biosimilars: There are currently no FDA-approved biosimilar or generic versions of Litfulo (ritlecitinib) available. This option is not available at this time.

2. Manufacturer savings card: If you have private insurance, you may qualify for Pfizer's Litfulo copay savings card, which can reduce your out-of-pocket costs. Apply or learn more at https://www.litfulo.com/copay-savings-card.

3. State Pharmaceutical Assistance Programs (SPAPs): Many states offer programs that help residents afford prescription medications, particularly for those on Medicare or with low incomes. Contact your state health department or visit your state's official website to find local programs.

4. NeedyMeds.org: This free, independent database lists hundreds of patient assistance programs, disease-specific funds, and other financial resources. Visit https://www.needymeds.org to search by drug name or condition at no cost.

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*This guide is for informational purposes only and does not constitute medical or legal advice. Eligibility determinations are made solely by Pfizer. Program terms may change — verify current requirements at [https://www.litfulo.com/support](https://www.litfulo.com/support) before applying.*

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