ABILIFY® (aripiprazole) Savings Program Terms and Conditions

RETAIL PHARMACY OPTION

With this Savings Card, eligible, commercially insured patients can save on their out-of-pocket costs and pay as little as $5 per co-pay for their ABILIFY prescriptions. When the co-pay for a 30-day supply is above $5, all eligible, commercially insured patients will pay the first $5, total benefit not to exceed the list price, as determined by Otsuka America Pharmaceutical, Inc. (OAPI) and communicated to your pharmacy. Any day dispenses are permissible within the terms of the program. This card must be activated by calling 1-888-922-4543. You can continue to use this card for as long as you are eligible or until this program is terminated. (Limit 1 card per patient.) The card is not transferable. Patients are not eligible if they pay cash for their prescriptions; or are covered in whole or in part by any state or federally funded programs, including, but not limited to, Medicare or Medicaid (including Medicaid managed care), Medigap, VA, DOD, or TRICARE. Only valid in U.S. and Puerto Rico, but not for residents of Massachusetts or where otherwise prohibited by law. Offer void where prohibited by law, taxed, or restricted. Other conditions may apply.

To receive the benefits of this program, you must present the Savings Card to your pharmacist along with a valid ABILIFY prescription. This program is not health insurance. OAPI has the right to rescind, revoke, or amend this program without notice. Your participation in this program confirms that this offer is consistent with your insurance coverage and that you will report the value received if required by your insurance provider. When you use this card, you are certifying that you understand and will comply with the program rules, terms, and conditions. For questions, please call 1-888-9-ABILIFY (1-888-922-4543) 8 am–7 pm ET, Monday–Friday.

MOBILE TERMS

By agreeing to the terms of ABILIFY Mobile Program (Program), you consent to receive autodialed text messages on behalf of Otsuka America Pharmaceutical, Inc.(OAPI). Consent is not a condition of purchase or use of any OAPI product. The Program is valid with most major US carriers. There is no fee payable to OAPI to receive text messages; however, your carrier’s message and data rates may apply.

Data obtained from you in connection with your registration for, and use of, this service may include your phone number, related carrier information, and elements of pharmacy claim information. This data will only be used to administer this program and to provide program benefits such as savings offers, information about your prescription, refill reminders, as well as program updates and alerts sent directly to your device.

Participants may receive an average of 5 messages per month during the course of this program. You may unsubscribe from the Program at any time by texting STOP. For help, text HELP or contact your mobile carrier. For questions about the program or the card call 1-888-922-4543. OAPI reserves the right to rescind, revoke or amend the Program without notice.


ABILIFY is available in 2 mg, 5 mg,10 mg,15 mg, 20 mg, and 30 mg Tablets

Please see U.S. FULL PRESCRIBING INFORMATION, including BOXED WARNING, and MEDICATION GUIDE.

© 2017 Otsuka America Pharmaceutical, Inc., Rockville, MD


May 2017         03US17EBC0018