Help eligible patients save on LINZESS*
Patients can take advantage of 90 days of treatment for the out-of-pocket cost of as little as $3027,28*
Based on IMS data, patients who initiate therapy with a 90-day LINZESS prescription average more annual days of therapy versus those who start therapy with a 30-day prescription.29
Program Terms, Conditions, and Eligibility Criteria:
1. This offer is valid only for patients 18 years of age or older and is good for use only with a valid prescription for LINZESS® (linaclotide) capsules 145 mcg or 290 mcg at the time the prescription is filled by the pharmacist and dispensed to the patient. 2. Depending on your insurance coverage, most eligible patients may pay as little as $30 per prescription fill for each of up to twelve (12) prescription fills. Check with your pharmacist for your copay discount. Maximum savings limit applies; patient out‑of‑pocket expense may vary. 3. This offer is not valid for use by patients enrolled in Medicare, Medicaid, or other federal or state programs (including any state pharmaceutical assistance programs), or private indemnity or HMO insurance plans that reimburse you for the entire cost of your prescription drugs. Patients may not use this card if they are Medicare‑eligible and enrolled in an employer‑sponsored health plan or prescription drug benefit program for retirees. This offer is not valid for cash‑paying patients. 4. This offer is valid for up to twelve (12) prescription fills. Offer applies only to prescriptions filled before the program expires on 7/31/17. 5. Allergan reserves the right to rescind, revoke, or amend this offer without notice. 6. Offer good only in the USA, including Puerto Rico, at participating retail pharmacies. 7. Void if prohibited by law, taxed, or restricted. 8. This card is not transferable. The selling, purchasing, trading, or counterfeiting of this card is prohibited by law. 9. This card has no cash value and may not be used in combination with any other discount, coupon, rebate, free trial, or similar offer for the specified prescription. 10. This offer is not health insurance. 11. This card expires July 31, 2017. 12. By redeeming this card, you acknowledge that you are an eligible patient and that you understand and agree to comply with the terms and conditions of this offer.
For questions about the program, including savings on mail‑order prescriptions, please call 1‑855‑226‑3937.
Pharmacist Instructions for a Patient with an Eligible Third Party Payer: When you redeem this card, you certify that you have not submitted and will not submit a claim for reimbursement under any federal, state, or other government programs for this prescription. Submit the claim to the primary Third Party Payer first, then submit the balance due to Therapy First Plus using BIN# 004682 as a Secondary Payer COB with patient responsibility amount and a valid Other Coverage Code (eg, 8). If you receive a rejection due to PA, step-edit, or NDC block, submit Other Coverage Code of 03 (secondary claim). Patient pays the first $30 plus any remaining balance after the maximum savings limit for the program is reached. Reimbursement will be received from Therapy First Plus. For any questions regarding online processing, call the Therapy First Plus Help Desk at 1‑800‑422‑5604.
Program managed by PSKW, LLC on behalf of Allergan.