Reduce patients’ out-of-pocket costs for ARISTADA INITIO® (aripiprazole lauroxil) and ARISTADA® (aripiprazole lauroxil). Patients with commercial insurance may be eligible to receive assistance to reduce their co-pay to as low as $10 per prescription. Enroll your patients to investigate eligibility.*
*Patients must be 18 years of age or older, have a prescription consistent with the Prescribing Information, and have commercial insurance only.
Patients are not eligible to participate in this program if they are enrolled in, or covered by, any local, state, federal, or other government program that pays for any portion of medication costs, including but not limited to Medicare, including Medicare Part D or Medicare Advantage plans; Medicaid, including Medicaid Managed Care and Alternative Benefit Plans (ABPs) under the Affordable Care Act; Medigap; VA; DOD; TRICARE; and any state funded programs such as medical or pharmaceutical assistance programs. If patient becomes eligible for any government program that pays for any portion of medication costs, they will no longer be eligible for this program. Program may be subject to plan benefit design requirements. This offer is not conditioned on any past, present, or future purchase, including refills. Alkermes reserves the right to rescind, revoke, or amend this offer, program eligibility, and requirements at any time without notice. This offer is limited to one per patient, may not be used with any other offer, is not transferable, and may not be sold, purchased, or traded, or offered for sale, purchase, or trade. Void where prohibited by law.
The ARISTADA Patient Assistance Program provides your uninsured or “functionally” uninsured patients, who meet program eligibility criteria, access to treatment at no charge, for up to 12 months.†
Definition of uninsured patients
The program requires that your patient (or patient’s designee) provide proof of income
If your patient cannot provide an IRS 1040 tax return as proof of income, download, complete, and submit the Provider Attestation Form AND one of the following items:
†The ARISTADA Patient Assistance Program does not cover or provide support for supplies, procedures, or any physician-related services associated with ARISTADA therapy.