VIMPAT PATIENT SAVINGS PROGRAM
NEARLY 75% OF ELIGIBLE PATIENTS* PAID AS LITTLE AS $20 PER 30-DAY SUPPLY OF VIMPAT WITH THE VIMPAT PATIENT SAVINGS PROGRAM.1
Ask your sales representative for details about the program.
Patients are responsible for a minimum of $20 out-of-pocket expense per 30-day supply. This card will then be applied toward any remaining out-of-pocket expense up to a maximum of $1300. Most patients who have commercial prescription insurance are eligible. If you have any questions regarding your eligibility or benefits or if you wish to discontinue your participation, call the VIMPAT Savings Program at 1-888-786-5879 (8:30 AM – 5:30 PM EST, Monday-Friday and 8:30 AM – 2:30 PM EST, Saturday). This savings card is not valid for use by patients who are covered by any federally funded or state-funded healthcare program (including, but not limited to Medicare [Part D and Medigap], Medicaid, any state pharmaceutical assistance program TRICARE, VA, or DoD). Offer good only in the US, including Puerto Rico. This card may only be used with a valid VIMPAT prescription at the time the prescription is filled by the pharmacist and dispensed to the patient. The maximum annual benefit amount is $1300 per calendar year. Void where prohibited by law, taxed, or restricted. This offer cannot be combined with any other promotional offer. UCB, Inc. reserves the right to rescind, revoke, or amend this offer without notice at any time. No cash value. Not eligible for sale, purchase, trade, or counterfeit.
When A Prior Authorization Is Required, CoverMyMeds® Can Provide Prior Authorization Assistance
CoverMyMeds® offers prior authorization (PA) assistance through an electronic-based system that standardizes the prior authorization process for most insurance providers, including Commercial, Medicare and Medicaid.*
Pharmacy-initiated PA requests
- If a prescription is submitted to a participating pharmacy and requires a PA, CoverMyMeds facilitates the approval process by delivering a PA to your office for completion, signature and submission to the health plan
- More than 90% of retail pharmacies participate in CoverMyMeds12
- CoverMyMeds also offers a web-based portal that can help your office by automating the PA process, saving prescribers and staff time and ensuring patients receive their medication faster
Currently, Medi-Cal, Washington State Medicaid, and Wisconsin State Medicaid require the pharmacy to submit prior authorization forms and may not be applicable to this program. This list is subject to change based on plan requirements.
†Year-to-date average does not indicate or guarantee an individual’s approval for VIMPAT.
FINANCIAL ASSISTANCE MAY BE AVAILABLE FOR VIMPAT PATIENTS.
The VIMPAT Patient Assistance Program may be able to help if your patients do not have health insurance or if they are a Medicare Part D recipient and cannot afford VIMPAT. Eligible patients are provided a free 6-month supply of medicine and can reapply every six months for continuing support.
To learn more about the VIMPAT Patient Assistance Program or to find out if your patient might be eligible for assistance, please contact UCBCares at 1-844-599-CARE (2273), or AskUCBCares.com, or click below to get started.
- 1.Data on file. UCB, Inc.
- 11.CoverMyMeds LLC, December 2017.
- 12.CoverMyMeds website: https://www.covermymeds.com/main/. Accessed October 9, 2017.