XIAFLEX® Copay Assistance Program
If eligible, you'll pay $0 out of pocket for XIAFLEX®*
How much you pay for XIAFLEX® will depend on your health benefits or insurance coverage.
The XIAFLEX® Copay Assistance Program can cover up to $1200 of your out-of-pocket costs for each injection of XIAFLEX®.
To find out if you qualify, call 1-800-743-2382.
Patients are eligible for assistance under this program if:
- You are receiving or have received XIAFLEX® for the approved indication and in a manner consistent with the instructions for administration of XIAFLEX®
- You are uninsured or have insurance that is not provided by Medicare, Medicare Prescription Drug Benefit plans, Medicare Advantage, Veterans Affairs (VA), Medicaid, or similar federal or state programs, and this program is not otherwise prohibited by law
- You are 18 years of age or older
- You have paid or are obligated to pay out-of-pocket costs for a prescription of XIAFLEX®
No other purchase is necessary to receive this offer.
For more information, call 1-800-743-2382.
- 1. By accepting this offer, you agree to report the value received under this offer to any health insurer or other third party paying for any part of the XIAFLEX® prescription if you are required to do so by benefit terms, contract, or law.
- 2. This offer is not valid for prescriptions reimbursed in whole or in part by Medicare, Medicare Prescription Drug Benefit plans, Medicare Advantage, VA, Medicaid, or similar federal or state programs, or where otherwise prohibited by law.
- 3. By accepting this offer, you agree that Endo Pharmaceuticals Inc. or those working on its behalf may contact your doctor to verify information about treatment that is relevant to verifying your eligibility for this offer.
- 4. This offer is only valid for doses of XIAFLEX® administered in the US.
- 5. This offer is valid for the out-of-pocket cost for the dose of XIAFLEX® only. Offer is not valid for any other products or other out-of-pocket costs (for example, office visit charges, office visit copays, or injection/administration costs), even if those costs are associated with the administration of a dose of XIAFLEX®.
- 6. This offer is valid only if you have not used this program within the last 30 days.
- 7. The selling, purchasing, trading, or counterfeiting of this offer is prohibited.
- 8. Endo Pharmaceuticals Inc. reserves the right to rescind, revoke, or amend this offer without notice.
- 9. By participating, you understand and agree to comply with the terms and conditions of this offer as set forth above.
Based on analysis of over 4000 claims filed January 2015 through October 2015.