Copays copay relief12/4/2023 ![]() Electrolyte abnormalities should be corrected. Providers should consider whether the benefits of androgen deprivation therapy outweigh the potential risks in patients with congenital long QT syndrome, congestive heart failure, or frequent electrolyte abnormalities and in patients taking drugs known to prolong the QT interval. QT/QTc Interval Prolongation: Androgen deprivation therapy, such as ORGOVYX is contraindicated in patients with severe hypersensitivity to relugolix or to any of the product IMPORTANT SAFETY INFORMATION & INDICATION Contraindication The ORGOVYX Copay Program is valid through December 31, 2024. Myovant Sciences reserves the right to revoke, rescind, or amend this offer without notice. Patient and participating pharmacists agree to report the receipt of Copay Program benefits to any insurer or other third party who pays for or reimburses any part of the prescription filled using the Card, as may be required by such insurer or third party. Patient and participating pharmacists agree not to seek reimbursement for all, or any part of the benefit received by the patient through this Copay Program. This offer is not conditioned on any past, present, or future purchase, including refills. This offer cannot be combined with any other coupon, free trial, discount, prescription savings card, or other offer. This Copay Program is void where prohibited by state law and on the date an AB generic equivalent for ORGOVYX becomes available. Patient must be a resident of the U.S., Puerto Rico, or U.S. Offer is not valid for cash-paying patients. The Copay Program is not valid 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. This Copay Program may not be redeemed more than once per 21 days. After the annual maximum of $10,000 for ORGOVYX is reached, patient will be responsible for the remaining monthly out-of-pocket costs. With this Copay Program, eligible patients will pay as little as $10 per month, subject to a maximum of $10,000 per calendar year. *The ORGOVYX Copay Assistance Program (“Copay Program”) is for eligible patients with commercial prescription insurance for ORGOVYX. You can also get more information by visiting a Co-Pay Assistance Foundations below.ORGOVYX COPAY ASSISTANCE PROGRAM: TERMS AND CONDITIONS Please note that this is not a summary of all of the eligibility criteria and that each program establishes its own guidelines for who is eligible for assistance and to what degree. and receive the care for the condition in the U.S. Demonstrate financial hardship, although some programs provide assistance to those making as much as 500 percent of the Federal Poverty Level, based on income and family size.Have some form of health insurance that includes some level of prescription drug coverage.Be prescribed one of the targeted medications.Be diagnosed with one of the currently covered conditions.While each program has its own set of eligibility criteria, most require that patients: However, if you or someone you know has been diagnosed with one of these diseases and cannot afford the medication, these organizations may be able to help. These Co-Pay Assistance Foundations provide assistance for those suffering from certain diseases - they do not provide assistance for all medicines or all conditions. Some conditions require drugs costing $100,000 per year or more, and, too often, the cost is simply not included in the patient’s insurance coverage.įortunately, there are Co-Pay Assistance Foundations that can help qualified patients receive these important medications. Many people suffering from life-threatening or rare diseases discover that, even if they have insurance, they cannot afford life-saving medications.
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