For US Health Care Professionals Only
CO-PAY ASSISTANCE
Most eligible patients paid a $0 prescription co-pay for GILENYA.* Two co-pay support programs that can help:
The GILENYA Prescription Co-Pay Support Program
To help ensure that treatment remains affordable, eligible patients can receive co-pay assistance for their GILENYA prescriptions. Payments are made directly to the patient’s pharmacy.*
The GILENYA Medical Co-Pay Support Program
Baseline assessments and the first-dose observation (FDO) performed through the GILENYA Assessment Network—whether in a medical facility or @Home—are provided free of charge to patients. The Medical Co-Pay Support Program may still help pay for most of these tests if conducted outside of the GAN.
*Limitations apply. Valid only for those with private insurance. The Program includes the Co-pay Card, Payment Card (if applicable), and Rebate, with a combined annual limit up to $18,000. Patient is responsible for any costs once limit is reached in a calendar year. Program not valid (i) under Medicare, Medicaid, TRICARE, VA, DoD, or any other federal or state health care program, (ii) where patient is not using insurance coverage at all, (iii) where the patient’s insurance plan reimburses for the entire cost of the drug, or (iv) where product is not covered by patient’s insurance. The value of this program is exclusively for the benefit of patients and is intended to be credited towards patient out-of-pocket obligations and maximums, including applicable co-payments, coinsurance, and deductibles. Program is not valid where prohibited by law. Patient may not seek reimbursement for the value received from this program from other parties, including any health insurance program or plan, flexible spending account, or health care savings account. Patient is responsible for complying with any applicable limitations and requirements of their health plan related to the use of the Program. Valid only in the United States and Puerto Rico. This Program is not health insurance. Program may not be combined with any third-party rebate, coupon, or offer. Proof of purchase may be required. Novartis reserves the right to rescind, revoke, or amend the Program and discontinue support at any time without notice.
Medical co-pay support for covered initial assessments/examinations or for First-Dose Observations (FDO) is provided without regard to whether the patient continues on with GILENYA therapy. People for whom GILENYA has been prescribed are required to report any benefits they receive under the GILENYA Medical Co-Pay Support Program to their insurance company. This offer is not valid for prescriptions and medical assessments for which payment may be made in whole or in part under federal or state health programs, including but not limited to Medicare or Medicaid, or for residents of RI. Valid only for those with commercial insurance. This program is subject to termination or modification at any time.
 
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