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For US Healthcare Professionals For US Patients
 * Assistance by Medication
   ADTHYZA® EDARBI® EDARBYCLOR® EPRONTIA® Horizant® Katerzia® KONVOMEP®
   Myhibbin™ Qbrelis® Triptodur® Vivimusta® Xatmep® ZONISADE®

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FINANCIAL SUPPORT OPTIONS FOR MYHIBBIN™ (MYCOPHENOLATE MOFETIL ORAL SUSPENSION)

Find medication coverage and patient financial assistance

Co-Pay & - Financial AssistancePatient & Caregiver Resources
Co-Pay &
Financial Assistance Patient & Caregiver Resources


CO-PAY & FINANCIAL ASSISTANCE FOR MYHIBBIN™

For coverage questions, we’ve got you covered. Coverage and assistance may vary
based on your insurance type.

I have commercial (private) insurance (1 program)

My health insurance is provided by my employer or I independently purchased it.




MONEY CO-PAY ASSISTANCE

Low
co-pay
Co-pay available for as little as Low* for commercially insured patients


YOUR OUT-OF-POCKET COST MATTERS TO US

Save with automatic co-pay support for Myhibbin™ at a pharmacy near you: no
calls, cards, or coupons necessary.


MORE THAN 70,000 PARTICIPATING PHARMACIES†

Paperless co-pay savings are available at virtually every pharmacy in the
country.

†Approximate participating pharmacies for eVoucherRx™ and Voucher on Demand™.


FIND A PHARMACY NEAREST YOU

Find a participating pharmacy in your area.

Search Now

 

*Eligibility Restrictions, Terms, and Conditions

By participating in this savings program, participants understand and agree that
the information provided, as well as non-personally identifiable information
obtained from the pharmacy, will be shared with the manufacturer and with any
companies working with the manufacturer. Participants also affirm that they will
not submit, and have not had submitted on their behalf, a claim for
reimbursement or coverage for items purchased with this card under Medicaid,
Medicare, TRICARE, or any other federal or state government healthcare program,
or where prohibited by state law.

 * Commercially insured patients may pay as little as $5. Benefit limitations
   apply.
 * Offer applies only to Myhibbin™ patients and associated refills

+ Learn More

 * This offer is not valid for prescriptions paid in part or in full by any
   federally or state‐funded program, including but not limited to Medicaid,
   Medicare, Department of Veterans Affairs, Department of Defense, or TRICARE,
   and where prohibited by law.
 * This savings program cannot be combined with any other coupon, cash discount
   card, certificate, voucher, or similar offer.
 * Offer good only in the USA at participating retail pharmacies and cannot be
   redeemed at government‐subsidized clinics. Void where taxed, restricted, or
   prohibited by law.
 * Offer not extended to clubs, groups, or organizations.
 * Participation in this program must comply with all applicable laws and
   contractual or other obligations as a pharmacy provider.
 * This is not an insurance program.
 * Participating patients and pharmacists understand and agree to comply with
   the Terms and Conditions of this offer as set forth herein.
 * Any step‐edits or prior authorizations required by the insurance plan still
   apply.
 * Azurity Pharmaceuticals, Inc. reserves the right to modify or cancel this
   program at any time.
 * eVoucherRx™ and Voucher on Demand™ are not extended on prescriptions for
   patients:
   * who are cash‐paying customers.
   * using institution-based pharmacies to fill their prescriptions, or who are
     recipients of federal or state government health care.
   * who are filling their prescriptions at nonparticipating pharmacies.



eVoucherRx™ is a trademark of RelayHealth.





Voucher on Demand™ is a trademark of eRx Network, LLC.





I currently don't have prescription drug insurance (1 program)

There are additional options available to you.




PIGGYBANK PATIENT ASSISTANCE PROGRAM

Your access to Myhibbin™ shouldn’t be limited by your ability to pay. The
Azurity Solutions Patient Assistance Program helps eligible patients get the
financial support they need.

844-472-2032

Azurity Solutions offers guidance on medication approval, access, and co-pays to
help eligible patients get their Azurity medications.


LEARN MORE ABOUT MYHIBBIN™

Click Here

Serving Overlooked PatientsSM

 * About Azurity Pharmaceuticals
 * Web Accessibility
 * Policy Terms of Use
 * Privacy Policy and Cookie Notice

©2024 Azurity Pharmaceuticals , Inc. All Rights Reserved. All Trademarks
referred to are the property of their respective owners.
Product packaging and imagery are for representation purposes only and shall
constitute the property of Azurity and all applicable affiliates.
The information contained herein, including product information, is intended
only for residents of the United States.
PP-AZS-US-0016




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