Eligibility

COMMERCIALLY INSURED PATIENTS WITH COVERAGE FOR ZEVENOX

Commercially insured patients who have coverage for ZEVENOX (covered patients) will receive their initial ZEVENOX 30 day prescription fill for as little as $0.

Covered patients who fill their prescription through the ZEVENOX Preferred Pharmacy Network (PPN), have at least one refill on their prescription and enroll or are enrolled in a qualifying auto-refill program through a participating PPN pharmacy, will receive ZEVENOX refills for as little as $0.

Covered patients filling their prescription through the ZEVENOX Preferred Pharmacy Network who do not participate in a qualifying auto-refill program, as well as covered patients utilizing the ZEVENOX copay card at a retail pharmacy, will pay as little as $0 for their initial 30-day fill and $30 or less / unit for ZEVENOX refills.

COMMERCIALLY INSURED PATIENTS WITHOUT COVERAGE FOR ZEVENOX

Commercially insured patients who do not have coverage (non-covered patients) for ZEVENOX and fill their prescription through the ZEVENOX Preferred Pharmacy Network will receive their initial ZEVENOX 30-day prescription fill for as little as $0 and will pay $50 or less per unit for refills.

ZEVENOX will pay the first $100 per unit for non-covered patients filling their ZEVENOX prescription outside of the ZEVENOX Preferred Pharmacy Network when utilizing the ZEVENOX copay card. Patients will be responsible for the remaining balance.

CASH PAYING PATIENTS

ZEVENOX will pay the first $100 per unit for cash paying patients when utilizing the ZEVENOX copay card. Patients will be responsible for the remaining balance.

ADDITIONAL TERMS AND CONDITIONS

• These offers are valid for patients 18 years of age or older and are good for use only with a valid prescription for ZEVENOX®.
• These offers are not valid for use by patients enrolled in Medicare, Medicaid and TRICARE or other federal or state programs. ZEVENOX reserves the right to rescind, revoke, or amend these offers without notice. These offers are good only in the USA, including Puerto Rico, at participating retail pharmacies. Void if prohibited by law, taxed, or restricted.
• These offers are not valid for prescriptions costs paid or reimbursed entirely by health benefit programs. Cash discount cards and other non-insurance plans are not valid as primary under these offers.
• Patient support benefits are limited to no more than two units per 30 day prescription fill.
• These offers and the ZEVENOX co-pay card have no cash value and may not be used in combination with any other discount, coupon, rebate, free trial, or similar offer. Out of pocket expenses for patients filling ZEVENOX prescriptions outside of the ZEVENOX Preferred Pharmacy Network or without the use of the ZEVENOX copay card may vary.

Eligible patients may call 1-800-ZEVENOX for other offers that may be available.