^aPADCEV Support Solutions is a component of Astellas Pharma Support Solutions^SM.

^bAstellas and Pfizer do not guarantee third-party coverage, payment, or reimbursement for denied claims. Coverage and reimbursement vary by payer, patient, and setting of care and are subject to change. Therefore, it is important that providers verify each patient's insurance coverage prior to initiating therapy. Each healthcare provider is ultimately responsible for determining coverage for individual patients.

^cThe healthcare provider remains responsible for populating all clinical information.

^dIMPORTANT INFORMATION: The coding, coverage, and payment information contained herein is gathered from various resources, general in nature, and subject to change without notice. Third-party payment for medical products and services is affected by numerous factors. It is always the provider's responsibility to determine the appropriate healthcare setting and to submit true and correct claims conforming to the requirements of the relevant payer for those products and services rendered. Pharmacies and providers submitting a claim should contact third-party payers for specific information on their coding, coverage, and payment policies. Information and materials provided by PADCEV Support Solutions are to assist pharmacies and other providers submitting a claim, but the responsibility to determine coverage, reimbursement, and appropriate coding for a particular patient and/or procedure remains at all times with the pharmacy and provider that submits the claim. Information provided by PADCEV Support Solutions or Astellas should in no way be considered a guarantee of coverage or reimbursement for any product or service.

^eAmerican Medical Association. Current Procedural Terminology® (CPT®). Professional edition, 2023. All rights reserved. Applicable FARS/DFARS Restrictions Apply to Government Use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT®, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

^fBy enrolling in the PADCEV Copay Assistance Program ("Program"), the patient acknowledges that they currently meet the eligibility criteria and will comply with the following terms and conditions: The Program is for eligible patients with commercial prescription insurance for PADCEV® (enfortumab vedotin-ejfv) and is good for use only with a valid prescription for PADCEV. The Program has an annual maximum copay assistance limit of $25,000 per calendar year. After the annual maximum on copay assistance is reached, patient will be responsible for the remaining out-of-pocket costs for PADCEV. The Program is not valid for patients insured by any state or federal healthcare 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 who move from commercial insurance to federal or state prescription health insurance will no longer be eligible, and agree to notify the Program of any such change. This offer is not valid for cash paying patients. Patients agree not to seek reimbursement from any health insurance or third party for all or any part of the benefit received by the patient through the Program. This offer is not conditioned on any past, present, or future purchase of PADCEV. This offer is not transferrable, has no cash value, and cannot be combined with any other offer, free trial, prescription savings card, or discount. The full value of the Program benefits is intended to pass entirely to the eligible patient. The benefit available under this Program is valid only for the patient's out-of-pocket medication costs for PADCEV. The benefit is not valid for any other out-of-pocket costs such as medication administration charges or other healthcare provider services. No other individual or entity (including, without limitation, third party payers, pharmacy benefit managers, or the agents of either) is entitled to receive any benefit, discount, or other amount in connection with this Program. This offer is not health insurance and is only valid for patients in the 50 United States, Washington DC, and Puerto Rico. This Program is void where prohibited by law. No membership fees. Certain rules and restrictions apply. Astellas reserves the right to revoke, rescind, or amend this offer without notice for any reason (including to ensure that the offer is utilized solely for the patient's benefit).

^gProgram is subject to eligibility criteria. Terms and conditions apply. Void where prohibited by law.

^hSupport is provided through third-party organizations that operate independently and are not controlled or endorsed by Astellas or Pfizer. Availability of support and eligibility requirements are determined by these organizations.