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The ALVESCO® (ciclesonide) Savings Program

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

Program Rules

*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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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.