More support for your patients with PsA, AS, or nr-axSpA
More insurance plans than ever are offering Taltz as the preferred IL-17A antagonist across Commercial and Medicare Part D1
FOR ELIGIBLE COMMERCIALLY INSURED PATIENTS
More support for your patients
IL-17A=interleukin-17A; PBM=prescription benefits manager; NPF=National Preferred Formulary; PA=prior authorization
*TERMS AND CONDITIONS
Offer good until 12/31/2024 or for up to 36 months from patient qualification into the program, whichever comes first. Patients must first use their card by 12/31/2022. Patients must have coverage for Taltz through their commercial drug insurance to pay as little as $5 for a 28-day supply of Taltz. Offer subject to a monthly cap and a separate annual cap. Patients must have commercial drug insurance and prescription consistent with FDA-approved product labeling to pay as little as $25 for a 28-day supply of Taltz. Participation in the $25 program requires submission of a prior authorization (PA). If coverage is denied, an appeal must be submitted prior to 5th month fill. A new PA and appeal or medical exception (ME) must be submitted every 12 months or as required by Lilly to verify coverage status and potential eligibility for the $5 program. Monthly and annual caps are set at Lilly’s absolute discretion and may be changed by Lilly with or without notice. Participation in the program requires a valid patient HIPAA authorization. Offer void where prohibited by law. Patient is responsible for any applicable taxes, fees, or amounts exceeding monthly or annual caps. This offer is invalid for patients without commercial drug insurance or whose prescription claims for Taltz are eligible to be reimbursed, in whole or in part, by any governmental program, including, without limitation, Medicaid, Medicare, Medicare Part D, Medigap, DoD, VA, TRICARE®️/CHAMPUS, or any state patient or pharmaceutical assistance program. Offer void where prohibited by law and subject to change or discontinue without notice. Card activation is required. Subject to additional terms and conditions, which can be found at taltz.com/patient-support.
†Contingent upon a patient scheduling a delivery with a specialty pharmacy.
‡Constitutes that a prior authorization (PA) has been submitted.
Additional Formulary Plan Information
This information is not a guarantee of coverage or payment (partial or full). Actual benefits are determined by each plan administrator in accordance with its respective policy and procedures. This list may not be an exhaustive list of all plans in your area and the coverage of other plans in your area may vary. Employers and employer groups may also offer additional benefit designs which may be different than described. The company/plan names listed do not imply their endorsement of Lilly USA, LLC or the product(s) referenced. Lilly USA, LLC does not endorse any particular plan.
Taltz Together™ is a trademark of Eli Lilly and Company.
TRICARE® is a registered trademark of the Department of Defense, Defense Health Agency.
Other company and product names are trademarks of their respective owners.
References: 1. Data on file. Lilly USA, LLC. DOF-IX-US-0243.