AFINITOR Co-Pay Card*
The AFINITOR Co-Pay Card limits a co-pay for eligible patients
- If eligible, most patients' co-pay for AFINITOR® (everolimus) Tablets will be no more than $25 per 28-day prescription
- Novartis Pharmaceuticals Corporation pays the remaining co-pay for AFINITOR, up to $6350 per month
To save on your AFINITOR prescriptions, complete the following steps:
Present your card to your pharmacist when picking up your AFINITOR prescription
*Terms & Conditions: Limitations apply. Offer not valid under Medicare, Medicaid, or any other federal or state program, or where plan reimburses you for entire cost of your prescription drug. Offer is not valid where prohibited by law. Valid only in the US and Puerto Rico. This program is not health insurance. Offer may not be combined with any other rebate, coupon, or offer. This card is the property of Novartis Pharmaceuticals Corporation and must be returned upon request. Novartis reserves the right to rescind, revoke, or amend the program without notice. Patient certifies responsibility for complying with applicable limitations, if any, of any commercial insurance and reporting receipt of program rewards, if necessary, to any commercial insurer. This offer expires on 12/31/2015.
Patient Instructions: Present this offer and your insurance card along with a valid prescription for AFINITOR® (everolimus) Tablets at any participating pharmacy or through mail order. If eligible, most patients will pay no more than $25 out of pocket. Novartis will pay the remaining balance up to $6350 per month. If this cap is reached, patient will be responsible for the difference. Offer expires 12/31/2015.
Patient questions should be directed to: 1-855-888-7208. When you use this offer, you are certifying that you understand the program rules, regulations, and terms and conditions, and that you will disclose and report the use of this offer as may be required by your insurer. You are not eligible if prescriptions are paid by any federal or state program, or where prohibited by law; and you will otherwise comply with the terms and conditions above.
Pharmacist Instructions: The AFINITOR $25 Co-Pay Card may be used for savings on AFINITOR. This card must be accompanied by a prescription for AFINITOR. For patients with insurance, please submit the co-pay authorized by the patient's primary insurance as a secondary transaction to OPUS Health. For cash-paying patients, submit the claim at U&C. You will receive a professional fee from OPUS Health with your next remittance. This card can be used by the patient once per month. This program cannot be combined with any other offers, discounts, or programs.
Pharmacist questions should be directed to OPUS Health: 1-800-364-4767. When you use this offer, you are certifying that you have not submitted and will not submit a claim for reimbursement under any federal, state, or other governmental programs for this prescription. Pharmacist will comply with his/her obligations when processing the prescription for payment. By using this card, you agree to the terms and conditions of this program.
Important Safety Information
Patients should not take AFINITOR if they are allergic to AFINITOR or to any of its ingredients. Patients should tell their health care provider before taking AFINITOR if they are allergic to sirolimus (Rapamune®) or temsirolimus (Torisel®).
Please see additional Important Safety Information at the bottom of this page.
Please see full Prescribing Information for AFINITOR, including Patient Information.
Important Safety Information
AFINITOR® (everolimus) Tablets can cause serious side effects, including lung or breathing problems, infections, and kidney failure, which can lead to death. Patients who take an angiotensin-converting enzyme (ACE) inhibitor medicine during treatment with AFINITOR are at a possible increased risk for a type of allergic reaction called angioedema. AFINITOR can cause incisions to heal slowly or not heal well. Mouth ulcers and mouth sores are common side effects, occurring in up to 86% of patients taking AFINITOR. AFINITOR can affect blood cell counts, kidney and liver function, and blood sugar and cholesterol levels. Regular blood tests should be performed before starting AFINITOR and as needed during treatment to check blood cell count, kidney and liver function, and blood sugar and cholesterol levels.
Please see additional