Activation

Program Terms, Conditions, and Eligibility Criteria

1. This offer is valid only for patients 18 years of age or older and is good for use only with a valid prescription for VRAYLAR^® (cariprazine) 1.5 mg, 3 mg, 4.5 mg, and/or 6 mg capsules at the time the prescription is filled by the pharmacist and dispensed to the patient.
2. This card is not valid for use by patients enrolled in Medicare, Medicaid, or other federal or state programs (including any state pharmaceutical assistance programs), or private indemnity or HMO insurance plans that reimburse you for the entire cost of your prescription drugs. Patients may not use this card if they are Medicare-eligible and enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees. This offer is not valid for cash-paying patients.
3. Depending on your insurance coverage, eligible patients may pay as little as $5 per 30-day supply for each of up to twelve (12) prescription fills or as little as $5 for each of up to four (4) 90-day prescriptions if VRAYLAR^® (cariprazine) is covered without coverage restrictions (eg, prior authorization, step therapy, or otherwise), and for those who are taking VRAYLAR^® (cariprazine) as an adjunctive or add-on treatment for Major Depressive Disorder, eligible patients may pay as little as $0 per 30-day supply for each of up to twelve (12) prescription fills or as little as $0 per 90-day supply for each of up to four (4) prescription fills of a generic antidepressant up to $200 per fill. In these instances, eligible patients who have not previously registered for a VRAYLAR^® (cariprazine) savings card may pay as little as $0 for their first two (2) 30-day prescription fills of VRAYLAR^® (cariprazine). Eligible patients whose insurer does not cover VRAYLAR^® (cariprazine) or where coverage restrictions have not been satisfied may pay as little as $75 per 30-day supply for each of up to twelve (12) prescription fills. Check with your pharmacist for your out-of-pocket discount. Maximum savings limit applies; patient out-of-pocket expense may vary.
4. Subject to all other terms and conditions, the maximum monthly benefit that may be available solely for the patient’s benefit under the copay assistance program is $3,250 for two 30-day prescription fills for eligible new patients, and $1,200 for a 30-day supply, $1,900 for a 60-day supply, and $3075 for a 90-day supply for existing patients. New patient offer only applies to 30-day prescription fills. The actual application and use of the benefit available under the copay assistance program may vary on a monthly, quarterly, and/or annual basis depending on each individual patient’s plan of insurance and other prescription drug costs.
5. AbbVie reserves the right to rescind, revoke, or amend this offer without notice.
6. Offer good only in the USA, including Puerto Rico, at participating retail pharmacies.
7. Void if prohibited by law, taxed, or restricted.
8. This card is not transferable. The selling, purchasing, trading, or counterfeiting of this card is prohibited by law.
9. This card has no cash value and may not be used in combination with any other discount, coupon, rebate, free trial, or similar offer for the specified prescription.
10. This offer is not health insurance.
11. 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.

For questions about the program,
including savings on mail-order prescriptions, please call 1-800-761-0436.