XIAFLEX® is covered by Medicare and for ~93% of claims for patients with commercial insurance.* Endo remains committed to helping eligible patients save on out-of-pocket costs for the only FDA-approved nonsurgical treatment option–XIAFLEX®. Eligible patients can receive up to $1200 toward out-of-pocket costs for each vial with the XIAFLEX® Copay Program. Restrictions apply.
*Based on insurance verification of >16,000 patient claims during the period of 1/1/15 – 12/31/15.
SAVE ON YOUR XIAFLEX® COPAY
Eligible patients save up to $1200 on out-of-pocket costs for each vial of XIAFLEX®
To download your card, please answer these questions and click the button below:
How did you hear about XIAFLEX®?
Check all that apply
When do you intend to seek treatment for your Dupuytren’s contracture?
Restrictions, Terms, and Conditions
- 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 your 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 or those working on its behalf may contact your HCP 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 reserves the right to rescind, revoke, or amend this offer without notice. You will have up to 365 days after receipt of your Explanation of Benefits (EOB) to submit this offer for processing.
- 9. By participating you understand and agree to comply with the terms and conditions of this offer as set forth above.
Please keep your copay card. You will need to provide information on it to the Specialty Pharmacy if your prescription for XIAFLEX® is processed through them.
Do I qualify?
How to use the copay card
What you do:
Take the copay card to your XIAFLEX® appointment and tell your HCP that you’d like to participate in the program.
What your HCP's office does:
If you are eligible, your HCP's office will be able to help you access program assistance. Once your insurance benefits have been determined, your HCP or the Specialty Pharmacy will let you know how much, if anything, you owe.
Based on how your HCP orders XIAFLEX®, you may also need to download and submit this form to facilitate reimbursement:
Download Reimbursement Form
If your HCP orders XIAFLEX® through a Specialty Pharmacy,
here is an additional download
that will help you.
How much can you save?
The XIAFLEX® Copay Program for eligible patients can cover up to $1200 for each vial of XIAFLEX®.
If Your Out-of-Pocket Cost for XIAFLEX® Is
For Eligible Patients, the
ADDITIONAL FINANCIAL ASSISTANCE PROGRAMS
The XIAFLEX® Copay Program is not the only way to get help with paying for your prescription.
To find out about additional financial assistance, call 877-XIAFLEX.