QULIPTA IS A PILL:
KEEPS MIGRAINE ATTACKS
AWAY OVER TIME
IN A 3-MONTH STUDY, QULIPTA SIGNIFICANTLY REDUCED MONTHLY MIGRAINE DAYS.
*Terms and Conditions apply. This benefit covers QULIPTA™ (atogepant). Eligible patients will receive copay assistance through one or more forms, such as a savings or copay card, and enrollment requirements may vary. Eligibility: Available to patients with commercial prescription insurance coverage for QULIPTA who meet eligibility criteria. The eligibility criteria varies by the form of copay assistance provided and will be made available to you as part of the enrollment process for the form or forms that you apply to receive. The program is not available to cash-paying patients or patients receiving prescription reimbursement under any federal, state, or government-funded insurance programs (for example, Medicare [including Part D], Medicare Advantage, Medigap, Medicaid, TRICARE, Department of Defense, or Veterans Affairs programs) or where prohibited by law or by the patient’s health insurance provider. If at any time a patient begins receiving prescription drug coverage under any such federal, state, or government-funded healthcare program, the patient will no longer be able to use the QULIPTA Complete Savings Card, and the patient must call 1.855.QULIPTA to stop participation. Patients may be eligible to receive up to twelve 30-day fills at no charge where coverage is not available until the insurer has established a coverage review process. Under this program, once an insurer has established a review process for coverage requests, eligible patients may receive up to a maximum of two 30-day fills at no charge for an FDA approved indication while coverage is pending. This payment may not be applied towards any out-of-pocket limits or other deductibles under patient’s insurance coverage. Patients residing in or receiving treatment in certain states may not be eligible. Patients may not seek reimbursement for value received from QULIPTA Complete from any third-party payers. Offer to enroll in the QULIPTA™ (atogepant) Copay Assistance Program is subject to change, reduction in amount of monetary assistance, or discontinuance without notice. Restrictions, including duration of the QULIPTA™ (atogepant) Copay Assistance program, available form(s) of copay assistance, and monthly maximums, may apply. Call 1.855.QULIPTA for more information. This assistance offer is not health insurance. 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. To learn about AbbVie’s privacy practices and your privacy choices, visit www.abbvie.com/privacy.html
To Pharmacists: For further information, please contact 800-364-4767.