REXULTI® (brexpiprazole) | OtsukaPatientSupport.com

REXULTI

Help paying for REXULTI

The REXULTI Savings Card offers two separate benefits for patients with commercial insurance.*

Eligible patients may pay as little as $0 for two months of REXULTI and $15 per refill, even for a 90-day prescription. For generic antidepressants, eligible patients may pay as little as $0 per month for new prescriptions and refills, with a maximum benefit of up to $100 per month.

Download or print a Savings Card and you could be eligible to start saving on your prescription.^†

Get a card

While costs vary, you can go to the REXULTI website to figure out what your prescription may cost, based on your insurance coverage.

If you don’t have insurance or have inadequate coverage, apply for additional assistance through the Otsuka Patient Assistance Foundation, Inc.

^*Consistent with the prescribing information for REXULTI.

^†This program is not health insurance. Further conditions apply.^‡

^‡The REXULTI Savings Card offer is not transferable. Patients are not eligible if they are under 18 years of age or are covered in whole or in part by any state program or federal healthcare program, including, but not limited to, Medicare or Medicaid (including Medicaid managed care), Medigap, VA, DOD, or TRICARE. Only valid in US and Puerto Rico. Offer void where prohibited by law, taxed, or restricted. Other restrictions may apply. This program is not health insurance. Otsuka America Pharmaceutical, Inc. has the right to rescind, revoke, or amend this program at any time 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. Offer not valid for cash-paying patients OR where drug is not covered by the primary insurance.

Prior authorization with CoverMyMeds

To help healthcare professionals create and manage prior authorization requests (PAs), we’ve collaborated with CoverMyMeds. Log in to an existing account or create a free account to seamlessly submit, track, and manage PAs.

Don’t have an account?
Create one on CoverMyMeds.com.

For in-person support, contact your local Patient Support Manager (PSM) at 1-855-242-7787.

Helpful Links and Resources

Use the resources listed below to connect with local community services^§

^‡These are independent third-party organizations that may offer services or support that are relevant to appropriate patients. These organizations are neither affiliated with nor endorsed by Otsuka Patient Support.

Details and Eligibility

For patients:

In order to redeem this offer you must have a valid prescription for ABILIFY MAINTENA® (aripiprazole). This offer may not be redeemed for cash. By using this offer, you are certifying that you meet the eligibility criteria (not a member of a federal, state, or government insurance program) and will comply with the terms and conditions described in the Restrictions section below. Patients with questions about the offer should call 1-888-591-9812.

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. As a condition of payment, you certify that you are in compliance with all program rules, terms, and conditions, as well as with any obligations to provide notice of your participation in this program to third-party payers as required by law, contract, or otherwise.

Submit the claim to the primary Third Party Payer first, then submit the balance due to Therapy First Plus as a Secondary Payer COB [coordination of benefits] with patient responsibility amount and a valid Other Coverage Code (eg, 8). Eligible patients are responsible for as little as $10, with up to $8,000 in annual savings. A valid Prescriber ID# is required on the prescription. Reimbursement will be received from Therapy First Plus. For any questions regarding Therapy First Plus online processing, please call the Help Desk at 1-800-422-5604.

For healthcare professionals:

When you apply for this offer, you are certifying that you have not submitted a claim for reimbursement under any federal, state, or other governmental programs for this prescription. Participation in this program must comply with all applicable laws and regulations as a pharmacy provider. By participating in this program, you are certifying that you will comply with the terms and conditions described in the Restrictions section below.

Restrictions:

This offer is only valid in the United States and Puerto Rico and is not transferable. Patients are not eligible if they are under 18 years of age or are covered in whole or in part by any state program or federal healthcare program, including, but not limited to, Medicare or Medicaid (including Medicaid managed care), Medigap, VA, DOD, or TRICARE. Offer void where prohibited by law, taxed, or restricted. Other restrictions may apply. This program is not health insurance. Otsuka America Pharmaceutical, Inc. has the right to rescind, revoke, or amend this program at any time 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. Program managed by PSKW, LLC on behalf of Otsuka America Pharmaceutical, Inc. Offer not valid for cash-paying patients OR where drug is not covered by the primary insurance.

Otsuka Patient SupportTM REXULTI® (brexpiprazole)

REXULTI

Financial support

Help paying for REXULTI

Prior authorization

Prior authorization with CoverMyMeds

Additional resources

Helpful Links and Resources

Education & advocacy

Financial assistance

Government programs

Details and Eligibility

For patients:

Pharmacist:

For healthcare professionals:

Restrictions:

Otsuka Patient Support^TM
REXULTI^®(brexpiprazole)