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

GET YOUR CARD TODAY
IN JUST 3 EASY 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 federal or state healthcare programs to pay for your VIVITROL prescription
  • You are being treated for alcohol or opioid dependence
GET YOUR CARD
VIVITROL® Co-pay Savings Program card

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
90% chart

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

WHO IS NOT ELIGIBLE?*

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

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 February 2017.
*Eligibility for Alkermes-Sponsored 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.