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QULIPTA LIST PRICE
The Wholesale Acquisition Cost (WAC), also known as the list price, for a 30-day supply of QULIPTA, is $991.00 as of January 2022. The WAC may not reflect the price paid by patients.
Call 1-855-QULIPTA (1-855-785-4782) Monday through Friday, 8 AM-8 PM ET to find out how much QULIPTA will cost for you.
INSURANCE INFORMATION*
*Important details about understanding your individual costs:
The chart above provides cost information based on what a person with the type of coverage listed may pay for. Your type of health or prescription insurance plan will determine exactly how much you will pay. Information listed is accurate as of January 2022 and is based on publicly available benefit design information for Medicaid and Medicare Part D out-of-pocket costs for 2022 plan year.
INSURANCE COVERAGE
SUPPORT
To help you understand your coverage and what your out-of-pocket costs may be, it’s important to verify your benefits.
Even if your QULIPTA isn’t covered, there may be ways to save on your prescription. QULIPTA Complete Insurance Specialists will help you understand your insurance coverage and identify the next steps to getting your prescribed treatment—regardless of your insurance coverage.
Call 1-855-QULIPTA (1-855-785-4782) Monday through Friday, 8 AM-8 PM ET to find out how much QULIPTA will cost for you.
SAVINGS & SUPPORT
MADE SIMPLE
The QULIPTA Complete Savings Card may make prescriptions cost as little as $0 a month† for eligible patients with commercial insurance.
Enroll today and learn how you could save on the cost of QULIPTA.
The QULIPTA Complete Savings Card may make prescriptions cost as little as $0 a month† for eligible patients with commercial insurance.
Enroll today and learn how you could save on the cost of QULIPTA.
myAbbVie Assist
If you are having difficulty paying for your medicine, myAbbVie Assist may be able to help.
myAbbVie Assist, our patient assistance program, provides AbbVie medicine to qualifying patients. It is intended for people that live in the United States, have limited or no health insurance coverage and demonstrate qualifying financial need.
Visit AbbVie.com/myAbbVieAssist to learn more.
†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.