Ask your doctor to help enroll you in the DURYSTA® Savings Program. It’s that simple.
To be eligible, you must:
- - Have commercial insurance coverage
- - Not receive reimbursement under any federal, state, or government-funded healthcare programs, such as Medicare or Medicaid
- - Be 18 years of age or older
- - Live in the US, including Puerto Rico and Guam.
- - Have DURYSTA® administered by June 30, 2024.
- - Agree to comply with the Program Terms, Conditions, and Eligibility Criteria below
Program Terms, Conditions, and Eligibility Criteria:
1. This offer is valid only for commercially-insured patients 18 years of age or older whose insurance plans cover DURYSTA® (bimatoprost intracameral implant) 10 mcg. 2. This offer is not valid for use by patients receiving reimbursement under any federal, state, or government-funded healthcare programs (e.g., Medicare, Medicare Advantage, Medigap, Medicaid, TRICARE, Department of Defense, or Veterans Affairs programs); private indemnity or HMO insurance plans that reimburse patients for the entire cost of their prescription drugs; or where prohibited by the patient’s health insurance provider. If at any time a patient begins receiving prescription drug coverage under any federal, state, or government-funded healthcare program, patient will no longer be eligible for this offer and must call IQVIA Inc. at 1-833-DURYSTA, option 2, to stop program participation. This offer is not valid for cash-paying patients. This offer is also not valid for commercially-insured patients whose insurance plans do not cover DURYSTA. 3. Depending on insurance coverage, eligible commercially-insured patients pay $0 for each eye up to one (1) DURYSTA implant per eye. This offer applies to the implant only and does not apply to costs for any other medication, procedure, or diagnostic service. Check with healthcare provider and insurance plan for discount. Patient out-of-pocket expense may vary. 4. Primary payer benefits must be applied prior to submitting a savings request on behalf of a patient. Patients may not seek reimbursement for value received from the DURYSTA Savings Program from any third-party payers. 5. Offer applies to implants administered during the current program period of July 1, 2023 through June 30, 2024. Claims must be submitted within 365 days of the treatment date and must include a copy of (a) an Explanation of Benefits (EOB) for DURYSTA®, (b) DURYSTA® Reimbursement Request Form, and (c) documentation from the physician’s office indicating the product code, the patient-paid amount, and the diagnosis of an FDA-approved indication. 6. Allergan, an AbbVie company, reserves the right to rescind, revoke, or amend this offer without notice. 7. Offer only good in the USA, including Puerto Rico and Guam. Patients residing in or receiving treatment in certain states may not be eligible to participate in this program. 8. Void if prohibited by law, taxed, or restricted. 9. This offer is not transferable. The selling, purchasing, trading, or counterfeiting of this offer is prohibited by law. 10. This offer has no cash value and may not be used in combination with any other discount, coupon, rebate, free trial, or similar offer for the specified prescription. 11. This offer is not health insurance. 12. Program expires June 30, 2024. 13. By redeeming this offer, patient represents they meet the eligibility criteria above, and the patient understands and agrees to comply with the terms and conditions of this offer. To learn about AbbVie privacy practices and your privacy choices, visit https://privacy.abbvie.
For questions about the program, please call 1-833-DURYSTA, option 2, or email [email protected].
Program managed by IQVIA Inc. on behalf of Allergan, an AbbVie company.