Patient Savings
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The DALVANCE CONNECTS℠ Patient Savings Program may assist eligible commercially insured patients with their out-of-pocket costs after patient pays the first $50 for DALVANCE, up to $800 per treatment course when administered in a practice-based or freestanding infusion center, hospital outpatient department, or home infusion service*
Eligible patients could pay as little as* $50 for a 5 mL bottle of PRED FORTE®
*Offer only valid for commercially insured patients and patients with Medicare Part D prescription drug insurance (including Medicare Advantage prescription drug plans), if the patient’s Medicare Part D prescription drug insurance does not cover PRED FORTE® or if the patient opts out of using their Medicare Part D prescription benefit in conjunction with this offer and the patient is responsible for the full cash payment for the prescription. Offer not valid for any uninsured patients, or patients with prescription coverage under any other federal or state health program such as Medicaid or TRICARE. See full Program Terms, Conditions, and Eligibility Criteria on the card.
*Offer only valid for commercially insured patients and patients with Medicare Part D prescription drug insurance (including Medicare Advantage prescription drug plans), if the patient’s Medicare Part D prescription drug insurance does not cover PRED FORTE® or if the patient opts out of using their Medicare Part D prescription benefit in conjunction with this offer and the patient is responsible for the full cash payment for the prescription. Offer not valid for any uninsured patients, or patients with prescription coverage under any other federal or state health program such as Medicaid or TRICARE. See full Program Terms, Conditions, and Eligibility Criteria on the card.
Eligible patients may pay as little as $15 for a 30- or 90‑day fill**
**Maximum savings limit applies; patient out-of-pocket expense may vary. Offer not valid for patients enrolled in Medicare, Medicaid, or other federal or state healthcare program. See Program Terms, Conditions, and Eligibility Criteria by clicking below.
**Maximum savings limit applies; patient out-of-pocket expense may vary. Offer not valid for patients enrolled in Medicare, Medicaid, or other federal or state healthcare program. See Program Terms, Conditions, and Eligibility Criteria by clicking below.
Most eligible patients may pay $0 for their first two 30-day fills and as little as $15 per 30-day refill*
Offer available starting January 1, 2020 and expires December 31, 2020.
*Depending on insurance coverage, eligible patients may pay as little as $15 for each of up to twelve (12) prescription fills. In such instances, eligible patients who have not previously registered for VRAYLAR® (cariprazine) savings card may pay as little as $0 for their first two (2) 30-day fills. Eligible patients whose insurer does not cover VRAYLAR® (cariprazine) or where coverage restrictions have not been satisfied may pay as little as $75 per 30-day supply for each of up to twelve (12) prescription fills. Check with your pharmacist for your copay discounts. Maximum savings limit applies; patient out-of-pocket expenses may vary. Offer not valid for patients enrolled in Medicare, Medicaid, or other federal or state health care programs. See full terms, conditions, and eligibility criteria on card.
Offer available starting January 1, 2020 and expires December 31, 2020.
*Depending on insurance coverage, eligible patients may pay as little as $15 for each of up to twelve (12) prescription fills. In such instances, eligible patients who have not previously registered for VRAYLAR® (cariprazine) savings card may pay as little as $0 for their first two (2) 30-day fills. Eligible patients whose insurer does not cover VRAYLAR® (cariprazine) or where coverage restrictions have not been satisfied may pay as little as $75 per 30-day supply for each of up to twelve (12) prescription fills. Check with your pharmacist for your copay discounts. Maximum savings limit applies; patient out-of-pocket expenses may vary. Offer not valid for patients enrolled in Medicare, Medicaid, or other federal or state health care programs. See full terms, conditions, and eligibility criteria on card.
Contact Allergan Medical Information toll-free at 1-800-678-1605.