SAVINGS CARD TERMS & CONDITIONS AND ELIGIBILITY CRITERIA
By using this coupon, you acknowledge that you meet the Eligibility Criteria and will comply with the Terms and Conditions.
Present this coupon to your pharmacy along with your valid VASCEPA prescription.
- You will pay the first $9 after your insurer's payment (if any) has been applied.
- We will pay up to the next $150 per 1-month fill and $450 per 3-month fill, up to a maximum savings of $2250 annually.
- Any additional amounts due are your responsibility.
If you have any questions, call 1-855-497-8462.
By applying this coupon, you are certifying that the patient meets the Eligibility Criteria.
Commercial Insurance Claims: Process a coordination of benefits (COB/split bill) claim.
- Use patient’s prescription insurance as PRIMARY.
- Then submit the balance due as SECONDARY to Change Healthcare with patient responsibility amount and a valid Other Coverage Code, (e.g., 8).
Cash-Paying Patients Without Insurance: Submit a PRIMARY claim to Change Healthcare with a valid Other Coverage Code (e.g., 1).
Submitting a claim for reimbursement under any state- or federally-funded prescription insurance program or where otherwise prohibited by any state, federal, or other law automatically voids this offer.
For processing help, call 1-800-422-5604.
ELIGIBILITY CRITERIA/TERMS AND CONDITIONS
- This offer is valid only for adult, eligible commercially insured patients with a valid VASCEPA prescription. This offer is also valid for adult cash-paying uninsured patients who agree not to submit a claim to any federal, state, or other healthcare program. The Savings card must be applied at the time of purchase.
- Patients enrolled in Medicare, Medicaid, TRICARE, or similar federal or state prescription drug insurance programs are not eligible for this offer.
- Offer may be used by eligible patients for a maximum savings of $2250 annually, for up to $150 per 1-month fill and $450 per 3-month fill.
- Offer only available in the United States. Void in the Commonwealth of Massachusetts (MA) and where otherwise prohibited, taxed, or restricted by a third party. It may not be redeemed for cash
- Offer is not transferable and may not be combined with any other savings offer or used for any other product. This is not health insurance.
- ConnectiveRx and Amarin Pharma, Inc. reserve the right to rescind, revoke, or amend this offer at any time with or without notice. It is a violation of federal law to buy, sell, or counterfeit this offer.
INDICATIONS AND IMPORTANT SAFETY INFORMATION
WHAT IS VASCEPA?
VASCEPA is a prescription medicine used:
- along with certain medicines (statins) to reduce the risk of heart attack, stroke and certain types of heart issues requiring hospitalization in adults with heart (cardiovascular) disease, or diabetes and 2 or more additional risk factors for heart disease.
- along with a low-fat and low-cholesterol diet to lower high levels of triglycerides (fats) in adults.
It is not known if VASCEPA changes your risk of having inflammation of your pancreas (pancreatitis).
It is not known if VASCEPA is safe and effective in children.
IMPORTANT SAFETY INFORMATION
WHO SHOULD NOT TAKE VASCEPA?
- Do not take VASCEPA if you are allergic to icosapent ethyl or any of the ingredients in VASCEPA.
WHAT ARE THE POSSIBLE SIDE EFFECTS OF VASCEPA?
VASCEPA may cause serious side effects, including:
- Heart rhythm problems (atrial fibrillation and atrial flutter). Heart rhythm problems which can be serious and cause hospitalization have happened in people who take VASCEPA, especially in people who have heart (cardiovascular) disease or diabetes with a risk factor for heart (cardiovascular) disease, or who have had heart rhythm problems in the past. Tell your doctor if you get any symptoms of heart rhythm problems such as feeling as if your heart is beating fast and irregular, lightheadedness, dizziness, shortness of breath, chest discomfort or you faint.
- Possible allergic reactions if you are allergic to fish or shellfish. Stop taking VASCEPA and tell your doctor right away or get emergency medical help if you have any signs or symptoms of an allergic reaction.
- Bleeding. Serious bleeding can happen in people who take VASCEPA. Your risk of bleeding may increase if you are also taking a blood thinner medicine.
If you have liver problems and are taking VASCEPA, your doctor should do blood tests during treatment. The most common side effects of VASCEPA include:
- Muscle and joint pain
- Swelling of the hands, legs, or feet
- Heart rhythm problems (atrial fibrillation)
These are not all the possible side effects of VASCEPA. Call your doctor for medical advice about side effects. You may report adverse events (i.e. side effects) or product complaints by contacting AmarinConnect at 1-855-VASCEPA (1-855-827-2372), emailing AmarinConnect@Amarincorp.com, or calling the FDA at 1-800-FDA-1088.
Tell your doctor if you take medicines that affect your blood clotting (anticoagulants or blood thinners).
For more information on VASCEPA, click here to see the full Patient Information or call 1-855-VASCEPA (1-855-827-2372).