UTIBRON NEOHALER Savings Program

Learn How Your Patients Can Pay As Little As $10 for UTIBRON NEOHALER*

Once you have prescribed UTIBRON NEOHALER, your patient can confirm his or her eligibility for co-pay savings at the filling pharmacy.

UTIBRON® savings brochure

UTIBRON® savings brochure

STEP 1:
Your patient should bring the UTIBRON NEOHALER Savings Brochure to his or her pharmacy

STEP 1:
Your patient should bring the UTIBRON NEOHALER Savings Brochure to his or her pharmacy

UTIBRON® cost savings

UTIBRON® cost savings

STEP 2:
Automatic savings will be applied at participating pharmacies*

STEP 2:
Automatic savings will be applied at participating pharmacies*

UTIBRON® NEOHALER® prescription savings card

UTIBRON® NEOHALER® prescription savings card

STEP 3:
If savings are not automatically applied, your patient can provide the pharmacy with the UTIBRON NEOHALER Prescription Savings Program Card* enclosed in the Savings Brochure

STEP 3:
If savings are not automatically applied, your patient can provide the pharmacy with the UTIBRON NEOHALER Prescription Savings Program Card* enclosed in the Savings Brochure


eVoucher Rx™ PROGRAM
As a participant in the eVoucherRx Program powered by RelayHealth, Sunovion has made it possible to extend prescription savings on to your patients. eVoucherRx is a paperless electronic coupon program that makes co-pay savings on UTIBRON NEOHALER easy for you and your patients.

PARTICIPATING PHARMACIES
When your patient presents his or her UTIBRON NEOHALER prescription at a participating pharmacy, eVoucherRx will automatically apply co-pay savings so your patient may pay as little as $10. For participating pharmacy locations, visit www.evoucherrx.relayhealth.com/storelookup.

OTHER PHARMACIES
Patients who do not have access to a participating pharmacy can present the UTIBRON NEOHALER Prescription Savings Program Brochure with card to their pharmacist to receive their savings. Prior to visiting the pharmacy, your patient should activate the card by calling 1-844-276-8262 or by visiting www.UTIBRON.com. Request savings cards for your patients below.

*Limitations apply. See program Terms and Conditions. This card is valid for up to $250 off each of up to 12 qualifying prescriptions of UTIBRON NEOHALER for up to a 30-day supply. Valid only for those with commercial insurance. This offer is not valid under Medicare, Medicaid, or any other federal or state program. Cash-paying patients will save up to $250 off the cost of their prescription. Sunovion Pharmaceuticals Inc. reserves the right to rescind, revoke, or amend this program without notice.


For patients who are not able to find an eVoucherRx participating pharmacy, you can request UTIBRON NEOHALER Savings Cards

UTIBRON® NEOHALER® co-pay card

UTIBRON® NEOHALER® co-pay card

Eligible patients pay as little as $10 co-pay.

Restrictions apply. UTIBRON NEOHALER Savings Program Terms & Conditions.

Get patients started with a free trial offer

UTIBRON® NEOHALER® 30-day free trial voucher card

UTIBRON® NEOHALER® 30-day free trial voucher card

Restrictions apply. UTIBRON NEOHALER Free Trial Program Terms & Conditions.

Restrictions apply. UTIBRON NEOHALER
Free Trial Program Terms & Conditions.

Help patients meet high deductibles

High-deductible discount card

High-deductible discount card

Save up to $400 per prescription on UTIBRON NEOHALER.§

§Restrictions apply. UTIBRON NEOHALER High-Deductible Discount Card Program Terms & Conditions.

Log in to request Savings Cards, Free Trial Offer, or High-Deductible Discount Cards.

Log in    REGISTER

 

Savings Card Terms and Conditions

By using this program, you acknowledge that you currently meet the following eligibility requirements:
You must be 18 years of age or older to accept this offer. This offer is valid only for eligible patients and legal guardians of eligible patients. Patients must have a valid prescription for UTIBRON NEOHALER within UTIBRON NEOHALER approved indication. Offer not valid if prescription is paid in part or full by any state or federally funded health care program, including but not limited to Medicare, Medicaid, VA, DoD or TRICARE, or where prohibited by law.

This program is valid for up to $250 off each prescription fill for up to a 30-day supply. The program is further limited to twelve (12) qualifying prescription fills. Offer is limited to one per person and may not be used with any other offer. This program is not health insurance. The amount of the benefit cannot exceed the patient’s out-of-pocket expenses.

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 payer. If requested or required by any such payer, the patient must report the use of this program. The patient must deduct the value of the savings received under this program from any reimbursement request submitted to the patient’s insurance plan, either directly or on the patient’s behalf.

For California and Massachusetts residents, benefits pursuant to this program will terminate automatically upon the introduction of a therapeutically equivalent product. Offer valid only in the United States and Puerto Rico. Void where prohibited by law, taxed or restricted. Sunovion reserves the right to rescind, revoke or amend this offer at any time without notice. This offer is not transferable and may not be sold, purchased, or traded, or offered for sale, purchase, or trade.

To the Patient: You must present this card, if applicable, to the pharmacist along with your prescription to participate in this program. If you have any questions regarding your eligibility or benefits, or if you wish to discontinue your participation, call the UTIBRON NEOHALER Savings Program at 1-844-276-8262 8:00AM—8:00PM (EST), Monday through Friday. By using this program, you are certifying that you understand the enclosed program rules, regulations, and terms and conditions; you have not submitted and will not submit a claim for reimbursement under any federal, state, or other governmental program for this prescription or where otherwise prohibited by law in your state; and you will otherwise comply with the terms mentioned herein.

To the Pharmacist: When you use this program, you are certifying that you have not submitted and will not submit a claim for reimbursement under any federal, state, or other governmental program for this prescription. If benefit does not apply automatically, submit transaction to McKesson Corporation using BIN #610524. If primary commercial prescription insurance exists, input program information as secondary coverage and transmit using the COB segment of the NCPDP transaction. Applicable discounts will be displayed in the transaction response. Acceptance of this program and your submission of claims for the program are subject to the LoyaltyScript® program Terms and Conditions posted at www.mckesson.com/mprstnc. Patient is not eligible if prescriptions are paid in part or full by any state or federally funded health care program, including but not limited to Medicare or Medicaid, VA, DoD or TRICARE, or where prohibited by law. For questions regarding setup, claim transmission, patient eligibility, or other issues, call the LoyaltyScript® Savings Program at 1-844-276-8262, 8:00AM—8:00PM (EST), Monday through Friday.

 

Free Trial Offer Terms and Conditions

Limit One TrialScript® voucher per patient. Redeem for product only when affixed to the back of a valid, signed prescription form for UTIBRON NEOHALER. Submit claim to McKesson Corporation using BIN #610524. For pharmacy processing questions, please call the Help Desk at 1-800-657-7613.

To the Patient: This voucher is good for one 30-day free trial of UTIBRON NEOHALER. Present this voucher at a participating pharmacy along with a valid prescription from your health care professional.
Need help? Call: 1-800-657-7613.

To the Pharmacist: Must be accompanied by a valid prescription for one 30-day supply of UTIBRON NEOHALER. Dispense as written at no cost to patient. For reimbursement, please submit to McKesson  Corporation. The information provided above should be used when submitting for reimbursement. Do not submit to any other payer, public or private, for reimbursement. This voucher can be used up to 2 times (once per 12-month period).

For questions, please call the Help Desk at 1-800-657-7613.

No substitutions permitted. No purchase required. This is not a discount or rebate. Limitations apply.

Expiration Date: 03/31/2019.

TrialScript® is a registered trademark of McKesson Corporation.

 

High-Deductible Discount Card Program Terms and Conditions

Restrictions apply. This card is valid for up to $400 off each of up to 3 qualifying prescriptions of UTIBRON NEOHALER, per calendar year, for a 30-day supply. For a 90-day prescription fill, this card may only be used once. Patient is responsible for any additional out-of-pocket costs above $400. Valid only for those with high-deductible commercial insurance. This offer is not valid under Medicare, Medicaid, or any other federal or state program. Cash-paying patients are not eligible. Offer is not valid where prohibited by law. Valid only in the US and Puerto Rico. This program is not health insurance. This card is the property of Sunovion Pharmaceuticals Inc. and must be returned upon request. Offer may not be combined with any other rebate, coupon, or offer. Sunovion Pharmaceuticals Inc. reserves the right to rescind, revoke, or amend this offer at any time. This offer will expire on 12/31/2018.

To the Patient: You must present this card to the pharmacist along with your prescription to participate in this program. If you have any questions regarding your eligibility or benefits, or if you wish to discontinue your participation, call the High-Deductible Discount Card Program at 833-477-0231 (8am-8pm ET Monday through Friday). When you use this card, you are certifying that you understand the program rules, regulations, and Terms and Conditions. You are not eligible if prescriptions are paid for by any state or other federally funded programs, including, but not limited to Medicare or Medicaid, VA, DOD, TRICARE, or where prohibited by law; and you will otherwise comply with the terms above.

To the Pharmacist: When you use this card, you are certifying that you have not submitted and will not submit a claim for reimbursement under any federal, state, or other governmental programs for this prescription.

  • Submit transaction to McKesson Corporation using BIN #610524
  • If patient has primary prescription insurance, input card information as secondary coverage and transmit using the COB segment of the NCPDP transaction. Applicable discounts will be displayed in the transaction response
  • Acceptance of this card and your submission of claims for the High-Deductible program are subject to the LoyaltyScript® program Terms and Conditions posted at www.mckesson.com/mprstnc
  • Patient is not eligible if prescriptions are paid for in part or full by any state or federally funded programs, including but not limited to Medicare or Medicaid, VA, DOD, TRICARE, or where prohibited by law
  • For questions regarding setup, claim transmission, patient eligibility or other issues, call the High-Deductible Discount Card Program at 833-477-0231 (8am-8pm ET Monday through Friday)

Important Safety Information & Indication

Important Safety Information

WARNING: ASTHMA-RELATED DEATH

Long-acting beta2-adrenergic agonists (LABAs) increase the risk of asthma-related death. Data from a large placebo-controlled US study that compared the safety of another LABA (salmeterol) or placebo added to usual asthma therapy showed an increase in asthma-related deaths in patients receiving salmeterol. This finding with salmeterol is considered a class effect of all LABAs, including indacaterol, one of the active ingredients in UTIBRON NEOHALER.

The safety and efficacy of UTIBRON NEOHALER in patients with asthma have not been established. UTIBRON NEOHALER is not indicated for the treatment of asthma.



All LABAs, including indacaterol, are contraindicated in patients with asthma without the use of a long-term asthma-control medication; UTIBRON NEOHALER is also contraindicated in patients with a history of hypersensitivity to indacaterol, glycopyrrolate, or to any of the ingredients.

UTIBRON NEOHALER should not be initiated in patients with acutely deteriorating or potentially life-threatening episodes of COPD or used as rescue therapy for acute episodes of bronchospasm. Acute symptoms should be treated with an inhaled short-acting beta2-agonist.

UTIBRON NEOHALER should not be used more often, at higher doses than recommended, or in conjunction with other medicines containing LABAs as an overdose may result. Patients who have been taking inhaled short-acting beta2-agonists on a regular basis should be instructed to discontinue their regular use and to use them only for symptomatic relief of acute respiratory symptoms. Clinically significant cardiovascular effects and fatalities have been reported in association with excessive use of inhaled sympathomimetic drugs. Patients using UTIBRON NEOHALER should not use another medicine containing a LABA for any reason.

Immediate hypersensitivity reactions have been reported with UTIBRON NEOHALER. If signs occur, discontinue immediately and institute alternative therapy. UTIBRON NEOHALER should be used with caution in patients with severe hypersensitivity to milk proteins.

As with other inhaled medicines, UTIBRON NEOHALER can produce paradoxical bronchospasm that may be life threatening. If paradoxical bronchospasm occurs following dosing with UTIBRON NEOHALER, it should be treated immediately with an inhaled, short-acting bronchodilator; UTIBRON NEOHALER should be discontinued immediately and alternative therapy instituted.

Indacaterol, like other beta2-adrenergic agonists, can produce a clinically significant cardiovascular effect in some patients as measured by increases in pulse rate, systolic or diastolic blood pressure, or symptoms. UTIBRON NEOHALER should be used with caution in patients with cardiovascular disorders, especially coronary insufficiency, cardiac arrhythmias, and hypertension. Beta2-adrenergic agonists may produce significant hypokalemia in some patients.

As with other beta2-adrenergic agonists, indacaterol should be administered with extreme caution in patients being treated with monoamine oxidase inhibitors, tricyclic antidepressants, or other drugs known to prolong the QTc interval because these agents may potentiate the action of adrenergic agonists on the cardiovascular system.

As with other beta2-adrenergic agonists, UTIBRON NEOHALER should be used with caution in patients treated with additional adrenergic drugs, non-potassium-sparing diuretics, and beta-blockers.

UTIBRON NEOHALER, like all medicines containing sympathomimetic amines, should be used with caution in patients with convulsive disorders, thyrotoxicosis, diabetes mellitus, ketoacidosis, and in patients who are unusually responsive to sympathomimetic amines.

UTIBRON NEOHALER should be used with caution in patients with narrow-angle glaucoma and in patients with urinary retention. Prescribers and patients should be alert for signs and symptoms of acute narrow-angle glaucoma (e.g., eye pain or discomfort, blurred vision, visual halos or colored images in association with red eyes from conjunctival congestion and corneal edema) and of urinary retention (e.g., difficulty passing urine, painful urination), especially in patients with prostatic hyperplasia or bladder-neck obstruction. Patients should be instructed to consult a physician immediately should any of these signs or symptoms develop.

The most common adverse events reported in ≥1% of patients taking UTIBRON NEOHALER, and occurring more frequently than in patients taking placebo, were nasopharyngitis (4.1% vs 1.8%), hypertension (2.0% vs 1.4%), back pain (1.8% vs 0.6%), and oropharyngeal pain (1.6% vs 1.2%).

UTIBRON capsules must not be swallowed as the intended effects on the lungs will not be obtained. UTIBRON capsules are only for oral inhalation and should only be used with the NEOHALER device.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

For additional information, please see the full Prescribing Information, including BOXED WARNING and Medication Guide, for UTIBRON NEOHALER.



Indication
 

UTIBRON® NEOHALER® (indacaterol and glycopyrrolate) is a combination of indacaterol and glycopyrrolate indicated for the long-term, maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema.

Important limitations: UTIBRON NEOHALER is not indicated to treat acute deteriorations of COPD and is not indicated to treat asthma.