The VIVITROL® Co-pay Savings Program covers up to $500/month of co-pay or deductible expenses for eligible patients with a VIVITROL prescription.* Terms and Conditions Apply.

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IN JUST 3 STEPS:

1YOU ARE ELIGIBLE
1CONFIRM YOUR ELIGIBILITY

You are not eligible for the VIVITROL® Co-pay Savings Program at this time, due to not meeting the minimum age requirements

Are you 18 years or older?

Please confirm that you are at least 18 years old.

Please select your insurance type(s).

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

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

CHECK ELIGIBILITY
2SIGN UP FOR THE PROGRAM
2SIGN UP FOR THE PROGRAM

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3GET YOUR CO-PAY CARD

Before you save and print your card, you must confirm:

  • You are 18 years or older
  • You are not using any federal or state healthcare programs to pay for your VIVITROL prescription
  • You are being treated for alcohol dependence or opioid dependence
GET YOUR CARD
$0 Copay up to $500/Month for eligible patients

Who is eligible for the co-pay savings program?

A 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 paying cash
90% of insured patients had no out-of-pocket costs for VIVITROL

90% of insured patients using the program had no out-of-pocket costs for VIVITROL.1

Who is not eligible for the co-pay savings program?

Patients using federal or state healthcare programs to purchase their VIVITROL prescription, including:

  • 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 and residential correctional programs

VIVITROL is not right for everyone. There are significant risks from VIVITROL treatment, including risk of opioid overdose, severe reaction at the injection site and sudden opioid withdrawal.
See Important Safety Information below. Discuss all benefits and risks with a healthcare provider. See Prescribing Information and Medication Guide.

Reference:

  1. Data derived from insured patients enrolled in the VIVITROL® Co-pay Savings Program from March 2016 through August 2018.

*Terms and Conditions

Eligibility for Alkermes-Sponsored Co-pay Savings. This offer is only available to patients 18 years or older, with a prescription consistent with the Prescribing Information and the patient is not enrolled in, or covered by, any local, state, federal or other government program that pays for any portion of medication costs, including but not limited to Medicare, including Medicare Part D or Medicare Advantage plans; Medicaid, including Medicaid Managed Care and Alternative Benefit Plans under the Affordable Care Act; Medigap; VA; DOD; TRICARE; or a residential correctional program.
Additional Terms of Use: This offer is not conditioned on any past, present, or future purchase, including refills. Alkermes reserves the right to rescind, revoke, or amend this offer, program eligibility, and requirements at any time without notice. This offer is limited to one per patient, may not be used with any other offer, is not transferable and may not be sold, purchased or traded, or offered for sale, purchase or trade. Void where prohibited by law. Program Administrator or its designee will have the right upon reasonable prior written notice, during normal business hours, and subject to applicable law, to audit compliance with this program.