here - Invokana

Transcription

here - Invokana
Savings Program
Instant savings on your private insurance co-pay, deductible, and coinsurance medication
costs for INVOKANA® (canagliflozin) or INVOKAMET™ (canagliflozin/metformin HCl).
INVOKANA® CarePath™/INVOKAMET™ CarePath™ Savings Card:
A Full-Year Program
12 MONTHS
Savings Card
BIN: 610020
Group: 99992248
Member: XXXXXXXXXX
Please read the accompanying full Prescribing Information and Medication Guide for
INVOKANA® (canagliflozin), or full Prescribing Information, including Boxed Warning
and Medication Guide for INVOKAMET™ (canagliflozin/metformin HCl), and discuss any
questions you have with your doctor.
SEE REVERSE. ACTIVATE CARD BEFORE USE. RESTRICTIONS APPLY.
NOTOCOST
YOU
*
To obtain and activate your Savings Card,
visit www.INVOKANACarePath.com
or www.INVOKAMETCarePath.com,
or call 1-877-468-6526.
* Per calendar year, subject to a $3,900 annual program benefit or 12 uses, whichever comes first.
Not valid for patients enrolled in Medicare Part D or Medicaid. See next page for eligibility/restrictions.
How to use your savings card:
» Use your Savings Card at your retail
pharmacy to receive instant savings
on your medication costs for
INVOKANA® or INVOKAMET™.
» Before the calendar year ends, a Care
Coordinator will contact you with
information and eligibility requirements
for a continued benefit in the program.
Visit www.INVOKANACarePath.com or
www.INVOKAMETCarePath.com for more resources:
» Help with understanding your insurance coverage
and potential out-of-pocket expenses.
» Referrals to a patient assistance program,
if you are eligible.
» Educational materials, reminder tools,
and information related to INVOKANA®
and INVOKAMET™.
1-877-468-6526 » Monday-Friday, 8:00 AM to 8:00 PM ET » www.INVOKANACarePath.com » www.INVOKAMETCarePath.com
Click to read the full Prescribing Information and Medication Guide for INVOKANA®, or full Prescribing Information,
including Boxed Warning and Medication Guide for INVOKAMET™, also available at www.INVOKANA.com and
www.INVOKAMET.com, and discuss any questions you have with your doctor.
See next page for eligibility/restrictions.
You may be eligible for INVOKANA® CarePath™/INVOKAMET™ CarePath™
Savings Program benefits if you:
» Have been prescribed INVOKANA® or INVOKAMET™
» Currently have commercial insurance
Other restrictions:
» This offer may not be combined with any other coupon, discount, prescription savings card, free trial, or other offer.
» This program is not available to individuals enrolled in federal or state subsidized healthcare programs that cover
prescription drugs, including Medicare, such as Medicare Part D prescription drug benefit, Medicaid, TRICARE, or
any other federal or state healthcare plan, including pharmaceutical assistance programs. Participants certify that
they will not seek reimbursement or compensation from any of these programs, to include a flexible spending
account, a Health Savings Account (HSA), or a Health Reimbursement Account (HRA).
» The selling, purchasing, trading, or counterfeiting of this card is prohibited.
» Offer good only in the U.S. and Puerto Rico. Janssen Pharmaceuticals, Inc., reserves the right to rescind, revoke,
or amend this offer without notice at any time. Void where prohibited, taxed, or otherwise restricted by law.
» Offer for new enrollment expires December 31, 2015. Before the calendar year ends, an INVOKANA® CarePath™
and INVOKAMET™ CarePath™ Care Coordinator will contact you with information and eligibility requirements for
continued savings on INVOKANA® or INVOKAMET™.
» For Massachusetts residents only, this offer may expire on July 1, 2015.
» Before you activate your card, it is important that you understand that you will be asked to provide personal
information that may include your name, address, phone number, e-mail address, and information related to your
insurance and treatment. This information is necessary to permit Janssen Pharmaceuticals, Inc., the manufacturer
of INVOKANA® and INVOKAMET™, and companies that work with Janssen Pharmaceuticals, Inc., including vendors
and other affiliates, to provide benefits to you related to the activation and use of your INVOKANA® CarePath™/
INVOKAMET™ CarePath™ Savings Card. The information you provide will be shared with companies
supporting the program and as required by law.
» As a condition of participating in this program, you must ensure that you comply with any co-payment disclosure
requirements of your insurance carrier or third-party payer, including disclosing to your insurer the amount of
co-payment support you receive from this program.
INVOKANA® CarePath™ and INVOKAMET™ CarePath™ , the Janssen Pharmaceuticals, Inc., support systems, are in
no way an extension of medical treatment provided by healthcare professionals to individual patients. You may
discontinue your participation at any time by calling 1-877-468-6526.
Janssen Pharmaceuticals, Inc.
Canagliflozin is licensed from Mitsubishi Tanabe Pharma Corporation.
© Janssen Pharmaceuticals, Inc. 2014
November 2014
024556-141105