Pharmacist Information

The ALVESCO® (ciclesonide) Savings Program

With the ALVESCO® (ciclesonide) Savings Program, patients can reduce co-pays to as little as $17 per prescription fill.* Your qualifying patients can save up to $75 each time they fill an ALVESCO® (ciclesonide) Inhalation Aerosol prescription, totaling up to $900 of savings each year.

*Most insured patients will pay no more than $17 monthly with a maximum benefit of $75 per fill. Restrictions apply and co-pay amounts may vary. See full program rules and eligibility.

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Pharmacists

Information for pharmacists about the ALVESCO® (ciclesonide) Savings Program

In these tough economic times, ALVESCO® (ciclesonide) Inhalation Aerosol may help asthma patients by reducing their co-pay to as low as $17 with the ALVESCO Savings Program Card.*

*Restrictions apply and co-pay amounts my vary. See Program Rules for details.

How It Works

  • For qualifying patients, the insurance co-pay can be reduced to as low as $17 if it is currently $75 or less. If the co-pay is more than $75 or the patient is paying cash, they will receive $75 in savings. Co-pay amounts may vary.
  • Discount available on up to twelve (12) prescription fills for ALVESCO.
  • Restrictions apply and co-pay amounts may vary. See Program Rules for details.

Help Your Asthma Patients Reduce Out-of-Pocket Cost
Let your asthma patients know about the co-pay program when they present a new or refill prescription for an inhaled corticosteroid (ICS). If they are interested in ALVESCO® (ciclesonide) Inhalation Aerosol:

  1. Offer to contact their healthcare provider to determine if ALVESCO is an appropriate option.
  2. Enroll the patient in the program by calling 1-855-834-3458, then press 2.

If the patient is qualified for the program, the claim will be available for processing within 30 minutes. Follow the instructions below.

Processing an Electronic Pharmacy Claim Is Easy
Simply follow these steps for electronic processing:

    1. Input primary insurance information first, if available.
    2. Enter the ALVESCO card information:

  • Rx Group Number
  • RX Bin Number 610524
  • Patient's ID number

    The card information should be entered:

  • As secondary insurance for patients with primary insurance
  • As primary insurance for patients paying cash

    3 .Submit the pharmacy electronic prescription transaction.

Applicable discounts on the co-pay amount will be applied and the cost to be collected from the patient will be displayed.

If your pharmacy does not accept loyalty cards, the patient can still get the benefit by requesting a refund for the co-pay. Simply instruct the patient to:

  1. Save the receipt from the ALVESCO prescription payment, and
  2. Contact the number on the card to request reimbursement

Note the card must be activated prior to use either online at www.alvesco.us or by calling 1-855-834-3458.

Program Support
For questions regarding setup, claims transmission, patient eligibility, or other issues, call the ALVESCO Savings Program at 1-855-834-3458, then press 2. Live pharmacy assistance is available from 8:00 AM – 8:00 PM EST, Monday through Friday.

ALVESCO® (ciclesonide) Savings Program Eligibility
Please be aware of the following program requirements:

  • Valid only for qualified customers with a valid prescription for ALVESCO® (ciclesonide) Inhalation Aerosol. No substitutions permitted.
  • Not valid for prescriptions covered or paid for by Medicare (including true out-of-pocket expenses under Medicare Part D), Medicaid, or any other federal or state healthcare programs, such as state pharmaceutical assistance programs.
  • Not valid for patients who are Medicare eligible and enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees (e.g. you are eligible for Medicare Part D but receive a prescription drug benefit through a former employer).
  • A parent or guardian must enroll in the ALVESCO Savings Program on behalf of a patient under 18 years of age.

Submission of claims for the ALVESCO Savings Program are subject to the LoyaltyScript® program Terms and Conditions established by McKesson Specialty Arizona Inc. By accepting and using this card from the patient, you agree: (i) to abide by the LoyaltyScript® program Terms and Conditions posted at http://mprsannounce.mckesson.com/MPRS/microsite/for_healthcare_professionals.htm and (ii) that your participation in this program is consistent with all applicable state laws and any obligations, contractual or otherwise, which you are subject to as a pharmacy provider

ALVESCO® (ciclesonide) Savings Program Rules: Patient Eligibility, Terms, and Conditions

Valid only for qualified customers with a valid prescription for ALVESCO® (ciclesonide) Inhalation Aerosol. No substitutions permitted.

A parent or guardian must enroll in the ALVESCO (ciclesonide) Savings Program on behalf of a patient under 18 years of age.

Not valid for prescriptions covered or paid for by Medicare (including true out-of-pocket expenses under Medicare Part D), Medicaid, or any other federal or state healthcare programs, such as state pharmaceutical assistance programs.

Not valid for patients who are Medicare eligible and enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees (i.e., you are eligible for Medicare Part D but receive a prescription drug benefit through a former employer).

Your discount with the ALVESCO (ciclesonide) Savings Program card is valid to reduce your co-pay to $17 with a maximum reduction of $75 per prescription. Discount available on up to twelve (12) prescription fills for ALVESCO per calendar year.

Your acceptance of this offer must be consistent with the terms of any drug benefit provided by a health insurer, health plan, or other third-party payor, and you agree to report acceptance of this offer to your health insurer, health plan, or third-party payor as may be required.

Offer limited to one card per person, and may not be used with any other discount, coupon, or offer.

Only an original ALVESCO (ciclesonide) Savings Program card or web-generated paper card will be accepted and must be presented to your pharmacist at the time you have the prescription filled—not valid if reproduced.

Offer valid only in the United States. Void where prohibited by law, taxed, or restricted.

Sunovion Pharmaceuticals Inc. reserves the right to change or discontinue this offer at any time without notice.

By participating in this program, you the patient certify that (a) you have read the above terms; (b) you are not reimbursed, nor will you submit a claim for reimbursement, nor will you seek to have any portion of this prescription counted toward your out-of-pocket costs (eg, TrOOP) under any federal, state, or private programs for this or other prescriptions for ALVESCO to which this offer will apply; and (c) you will otherwise comply with the terms above.

Using mail-order pharmacies

Check with your mail-order pharmacy to see if they accept loyalty cards such as the ALVESCO (ciclesonide) Savings Program card (most of them do). If they do, all you need to do is submit a photocopy of your card along with your prescription and insurance card information.

For mail-order pharmacies that do not accept loyalty cards, we will reimburse you $75. Please call 1-855-834-3458 or visit http://www.patientrebateonline.com to request a form that you can fill out and return to us, along with a copy of your receipt. We will then issue you a check.

Important Safety Information & Indication

ALVESCO is contraindicated in the primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required.

Rare cases of hypersensitivity reactions with manifestations such as angioedema, with swelling of the lips, tongue, and pharynx, have been reported.

The development of localized infections of the mouth and pharynx with Candida albicans have occurred infrequently. When such an infection develops, it may be necessary to interrupt therapy with ALVESCO. Most cases of candida infection were mild to moderate.

ALVESCO is NOT indicated for the relief of acute bronchospasm.

Patients who are using immunosuppressant doses of corticosteroids are more susceptible to infections than healthy individuals. Chicken pox and measles can have a more serious or even fatal course in susceptible individuals. Inhaled corticosteroids should be used with caution, if at all, in patients with active or quiescent tuberculosis infections of the respiratory tract; untreated local or systemic fungal or bacterial infections, systemic viral or parasitic infections; or ocular herpes simplex because of the potential for worsening of these infections.

Particular care is needed for patients who are transferred from systemically active corticosteroids due to the potential for adrenal insufficiency. Patients should taper slowly from systemic corticosteroids if switching to ALVESCO.

It is possible that systemic corticosteroid effects such as hypercorticism and adrenal suppression may appear in a small number of patients particularly when ALVESCO is administered at higher than recommended doses over prolonged periods of time. If such effects occur, the dosage of ALVESCO should be reduced slowly, consistent with accepted procedures for reducing systemic corticosteroids and management of asthma.

Decreases in bone mineral density have been observed with long-term administration of inhaled corticosteroids. Patients with major risk factors for decreased bone mineral content should be monitored and treated with established standards of care.

Orally inhaled corticosteroids may cause reduction in growth velocity when administered to pediatric patients. Monitor the growth of pediatric patients receiving ALVESCO. To minimize the systemic effects, patients should be titrated to the lowest dosage that effectively controls symptoms.

Glaucoma, increased intraocular pressure, and cataracts have been reported following the administration of inhaled corticosteroids including ALVESCO. Therefore, close monitoring is warranted in patients with a change in vision or with a history of increased intraocular pressure, glaucoma, and/or cataracts.

If bronchospasm occurs following dosing with ALVESCO, it should be treated immediately with a fast-acting inhaled bronchodilator.

The most common adverse reactions occurring at an incidence greater than or equal to 3% in any of the ALVESCO groups and which were more frequent with ALVESCO compared with placebo were headache, nasopharyngitis, sinusitis, pharyngolaryngeal pain, upper respiratory infection, arthralgia, nasal congestion, pain in extremity, and back pain.

Full Prescribing Information for ALVESCO

Indication
ALVESCO® (ciclesonide) Inhalation Aerosol is indicated for the maintenance treatment of asthma as prophylactic therapy in adult and adolescent patients 12 years of age and older.