Patient Information

Help your patients save on VIVITROL®

The VIVITROL® (naltrexone for extended-release injectable suspension) Co-pay Savings Program covers up to $500/month of VIVITROL co-pay or deductible expenses for eligible patients.

Get your patient's card today in just 3 easy steps:

Print your Co-Pay Card

You are eligible for the VIVITROL® Co-pay Savings Program. You can print your co-pay card right now to start saving on your treatment.

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Sign your patient up for the program
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Is your patient 18 years or older?


What type of insurance will your patient use to pay for their VIVITROL prescription (select all that apply)?

Note: patients using federal or state healthcare programs to purchase their VIVITROL prescription are not eligible.

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Your patient is eligible
Sign your patient up for the program
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Before you can save and print your patient's card, you must confirm:

  • Your patient is 18 years or older
  • Your patient is not using any federal or state healthcare programs to pay for their VIVITROL prescription
  • Your patient is being treated for alcohol or opioid dependence
Get your patient's card

Reference:
1. Data derived from insured patients enrolled in the VIVITROL® Co-pay Savings Program from March 2014 through February 2015.

*Eligibility for Alkermes-Sponsored VIVITROL® Co-pay Assistance:
Offer valid only for prescriptions for FDA-approved indications. You must be at least 18 years old. If you are purchasing your Vivitrol prescriptions with benefits from Medicare, including Medicare Part D or Medicare Advantage plans; Medicaid, including Medicaid Managed Care or Alternative Benefit Plans (“ABPs”) under the Affordable Care Act; Medigap; Veterans Administration (“VA”); Department of Defense (“DoD”); TriCare®; or any similar state funded programs such as medical or pharmaceutical assistance programs, you are not eligible for this offer. Void where prohibited by law, taxed or restricted. Alkermes, Inc. reserves the right to rescind, revoke or amend these offers without notice.

: PRINT CO-PAY CARD

Your patient’s VIVITROL® Co-pay Savings Program card

The pharmacy (specialty or other) will call your patient to confirm their prescription. Please instruct your patient to provide the RxID number on their co-pay card when requested by the pharmacy (specialty or other).

Sorry, your patient is not eligible

Your patient does not meet the eligibility criteria for the VIVITROL® (naltrexone for extended-release injectable suspension) Co-pay Savings Program.






91%1 of insured patients using the program had no out‑of‑pocket expenses for VIVITROL.*

Who is eligible*?

Any patient with a prescription for VIVITROL for alcohol or opioid dependence who is 18 years or older can apply for the VIVITROL® Co-pay Savings Program card. Eligible participants include:

  • Patients with commercial health insurance
  • Patients with no insurance or electing not to use insurance

Who is not eligible*?

Patients using federal or state healthcare programs to purchase their VIVITROL prescription. View listCollapse list

  • Medicare, including Medicare Part D or Medicare Advantage plans
  • Medicaid, including Medicaid Managed Care or Alternative Benefit Plans under the Affordable Care Act
  • Medigap
  • Veterans Administration
  • Department of Defense
  • TriCare®
  • State-funded programs such as medical or pharmaceutical assistance programs



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You have successfully emailed the patient their new VIVITROL® Co-pay Savings Program card.

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Require assistance with completing these fields?

Please call 1-800-VIVITROL, option 5.

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Terms and Conditions

I certify that I am at least 18 years old, I am being treated for opioid dependence after detox or alcohol dependence and that my prescription coverage is NOT under Medicaid, Medicare, TRICARE®, or any federal or state healthcare program, including any state medical or pharmaceutical assistance program.

Important Safety Information

INDICATIONS

VIVITROL is indicated for:

  • Treatment of alcohol dependence in patients who are able to abstain from alcohol in an outpatient setting. Patients should not be actively drinking at the time of initial VIVITROL administration.
  • Prevention of relapse to opioid dependence, following opioid detoxification.
  • VIVITROL should be part of a comprehensive management program that includes psychosocial support.

CONTRAINDICATIONS

VIVITROL is contraindicated in patients:

  • Receiving opioid analgesics
  • With current physiologic opioid dependence
  • In acute opioid withdrawal
  • Who have failed the naloxone challenge test or have a positive urine screen for opioids
  • Who have exhibited hypersensitivity to naltrexone, polylactide-co-glycolide (PLG), carboxymethylcellulose, or any other components of the diluent

WARNINGS/PRECAUTIONS

Vulnerability to Opioid Overdose: Because VIVITROL blocks the effects of exogenous opioids for approximately 28 days after administration, patients are likely to have a reduced tolerance to opioids after opioid detoxification. As the blockade dissipates, use of previously tolerated doses of opioids could result in potentially life-threatening opioid intoxication (respiratory compromise or arrest, circulatory collapse, etc). Cases of opioid overdose with fatal outcomes have been reported in patients who used opioids at the end of a dosing interval, after missing a scheduled dose, or after discontinuing treatment. Patients and caregivers should be told of this increased sensitivity to opioids and the risk of overdose.

Any attempt by a patient to overcome the VIVITROL blockade by taking opioids may lead to fatal overdose. Patients should be told of the serious consequences of trying to overcome the opioid blockade.

Injection Site Reactions: VIVITROL injections may be followed by pain, tenderness, induration, swelling, erythema, bruising, or pruritus; however, in some cases injection site reactions may be very severe. Injection site reactions not improving may require prompt medical attention, including, in some cases, surgical intervention. Inadvertent subcutaneous/adipose layer injection of VIVITROL may increase the likelihood of severe injection site reactions. Select proper needle size for patient body habitus, and use only the needles provided in the carton. Patients should be informed that any concerning injection site reactions should be brought to the attention of their healthcare provider.

Precipitation of Opioid Withdrawal: Withdrawal precipitated by administration of VIVITROL may be severe. Some cases of withdrawal symptoms have been severe enough to require hospitalization and management in the ICU. To prevent precipitated withdrawal, patients, including those being treated for alcohol dependence:

  • Should be opioid-free (including tramadol) for a minimum of 7–10 days before starting VIVITROL.
  • Patients transitioning from buprenorphine or methadone may be vulnerable to precipitated withdrawal for as long as two weeks.

Patients should be made aware of the risk associated with precipitated withdrawal and be encouraged to give an accurate account of last opioid use.

Hepatotoxicity: Cases of hepatitis and clinically significant liver dysfunction have been observed in association with VIVITROL. Warn patients of the risk of hepatic injury; advise them to seek help if experiencing symptoms of acute hepatitis. Discontinue use of VIVITROL in patients who exhibit acute hepatitis symptoms.

Depression and Suicidality: Alcohol- and opioid-dependent patients taking VIVITROL should be monitored for depression or suicidal thoughts. Alert families and caregivers to monitor and report the emergence of symptoms of depression or suicidality.

When Reversal of VIVITROL Blockade Is Required for Pain Management: For VIVITROL patients in emergency situations, suggestions for pain management include regional analgesia or use of non-opioid analgesics. If opioid therapy is required to reverse the VIVITROL blockade, patients should be closely monitored by trained personnel in a setting staffed and equipped for CPR.

Eosinophilic Pneumonia: Cases of eosinophilic pneumonia requiring hospitalization have been reported. Warn patients of the risk of eosinophilic pneumonia and to seek medical attention if they develop symptoms of pneumonia.

Hypersensitivity Reactions: Patients should be warned of the risk of hypersensitivity reactions, including anaphylaxis.

Intramuscular Injections: As with any IM injection, VIVITROL should be administered with caution to patients with thrombocytopenia or any coagulation disorder.

ADVERSE REACTIONS

Serious adverse reactions that may be associated with VIVITROL therapy in clinical use include severe injection site reactions, eosinophilic pneumonia, serious allergic reactions, unintended precipitation of opioid withdrawal, accidental opioid overdose, and depression and suicidality. The adverse events seen most frequently in association with VIVITROL therapy for alcohol dependence include nausea, vomiting, injection site reactions (including induration, pruritus, nodules, and swelling), muscle cramps, dizziness or syncope, somnolence or sedation, anorexia, decreased appetite or other appetite disorders. The adverse events seen most frequently in association with VIVITROL in opioid-dependent patients also include hepatic enzyme abnormalities, injection site pain, nasopharyngitis, insomnia, and toothache.

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

As of December 8, 2015, VIVITROL® (naltrexone for extended-release injectable suspension) has new Prescribing Information (12/2015). The Dosage and Administration, Section 2.4 Directions for Use has been updated. When administering VIVITROL, please refer to Section 2.4 Directions for Use in the VIVITROL Prescribing Information that is provided in the carton you are administering.