Savings Card

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ABILIFY MAINTENA® (aripiprazole)

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*Conditions apply. Please see below for full details.

Only intended for use on Apple and Google devices.

 

Please read FULL PRESCRIBING INFORMATION, including BOXED WARNING, and MEDICATION GUIDE.

You may be eligible to start saving on your ABILIFY MAINTENA prescription. You can start saving by doing one of the following:

Take this Savings Card and your valid prescription for ABILIFY MAINTENA to the pharmacy. Your pharmacist will file your claim for you.

OR

Give this Savings Card to your healthcare provider and ask him or her to call in your valid prescription for ABILIFY MAINTENA with the Savings Card information.

Details and Eligibility

For Patients: In order to redeem this offer you must have a valid prescription for ABILIFY MAINTENA® (aripiprazole). This offer may not be redeemed for cash. By using this offer, you are certifying that you meet the eligibility criteria (not a member of a federal, state, or government insurance program) and will comply with the terms and conditions described in the Restrictions section below. Patients with questions about the offer should call . Patient may pay as little as $10 with an annual maximum benefit of $8,000 and monthly $1,400 maximum. Presumes only 1 prescription filled per calendar month.

Pharmacist: When you use this card, you are certifying that you have not submitted and will not submit a claim for reimbursement under any federal, state, or other governmental programs for this prescription. As a condition of payment, you certify that you are in compliance with all program rules, terms, and conditions, as well as with any obligations to provide notice of your participation in this program to third-party payers as required by law, contract, or otherwise.

Pharmacist Instructions for a Patient with an Eligible Third Party: Submit the claim to the primary Third-Party Payer first, then submit the balance due to CHANGE HEALTHCARE as a Secondary Payer coordination of benefits with patient responsibility amount and a valid Other Coverage Code (e.g., 8). For ABILIFY MAINTENA prescription, patient may pay as little as $10 with an annual maximum benefit of $8,000 and monthly $1,400 maximum. Reimbursement will be received from CHANGE HEALTHCARE.

Valid Other Coverage Code Required. For any questions regarding CHANGE HEALTHCARE online processing, please call the Help Desk at .

For Healthcare Professionals: When you apply for this offer, you are certifying that you have not submitted and will not submit a claim for reimbursement under any federal, state, or other governmental programs for this prescription. Participation in this program must comply with all applicable laws and regulations as a pharmacy provider. By participating in this program, you are certifying that you will comply with the terms and conditions described in the Restrictions section below.

Restrictions: This offer is only valid in the United States and Puerto Rico, and is not transferable. Patients are not eligible if they are under 18 years of age, or are covered in whole or in part by any state program or federal healthcare program, including, but not limited to, Medicare or Medicaid (including Medicaid managed care), Medigap, VA, DOD, or TRICARE. Offer void where prohibited by law, taxed, or restricted. Other restrictions may apply. This program is not health insurance. Otsuka America Pharmaceutical, Inc. has the right to rescind, revoke, or amend this program at any time without notice. Your participation in this program confirms that this offer is consistent with your insurance coverage and that you will report the value received if required by your insurance provider. When you use this card, you are certifying that you understand and will comply with the program rules, terms, and conditions. Program managed by PSKW, LLC on behalf of Otsuka America Pharmaceutical, Inc. Offer not valid for cash-paying patients OR where drug is not covered by the primary insurance.

Please read FULL PRESCRIBING INFORMATION, including BOXED WARNING, and Medication Guide.

INDICATIONS and IMPORTANT SAFETY INFORMATION for ABILIFY MAINTENA® (aripiprazole)

IMPORTANT SAFETY INFORMATION and INDICATIONS for ABILIFY MAINTENA® (aripiprazole)
IMPORTANT SAFETY INFORMATION

IMPORTANT SAFETY INFORMATION

Elderly people with dementia-related psychosis are at increased risk of death when treated with antipsychotic medicines including ABILIFY MAINTENA. ABILIFY MAINTENA is not for the treatment of people who have lost touch with reality (psychosis) due to confusion and memory loss (dementia).

Do not receive ABILIFY MAINTENA if you are allergic to aripiprazole or any of the ingredients in ABILIFY MAINTENA. Allergic reactions to aripiprazole have ranged from rash, hives and itching to anaphylaxis, which may include difficulty breathing, tightness in the chest, and swelling of the mouth, face, lips, or tongue.

ABILIFY MAINTENA may cause serious side effects including:

  • Increased risk of stroke and ministroke has been reported in clinical studies with oral aripiprazole of elderly people with dementia-related psychosis and can lead to death.
  • Neuroleptic malignant syndrome (NMS), a serious condition that can lead to death. Call your healthcare provider or go to the nearest emergency room right away if you have some or all of the following symptoms of NMS: high fever, stiff muscles, confusion, sweating, or changes in pulse, heart rate, and blood pressure.
  • Uncontrolled body movements (tardive dyskinesia). ABILIFY MAINTENA may cause movements that you cannot control in your face, tongue, or other body parts. Tardive dyskinesia may not go away, even if you stop receiving ABILIFY MAINTENA. Tardive dyskinesia may also start after you stop receiving ABILIFY MAINTENA.
  • Problems with your metabolism such as:
    • High blood sugar (hyperglycemia): Increases in blood sugar can happen in some people who receive ABILIFY MAINTENA. Extremely high blood sugar can lead to coma or death. If you have diabetes or risk factors for diabetes (such as being overweight or a family history of diabetes), your healthcare provider should check your blood sugar before you start receiving ABILIFY MAINTENA and during your treatment.

    Call your healthcare provider if you have any of these symptoms of high blood sugar while receiving ABILIFY MAINTENA:

  • feel very thirsty

  • need to urinate more than usual

  • feel very hungry

  • feel weak or tired

  • feel sick to your stomach

  • feel confused, or your breath smells fruity

  • Increased fat levels (cholesterol and triglycerides) in your blood.
  • Weight gain. You and your healthcare provider should check your weight regularly.
  • Unusual urges. Some people receiving ABILIFY MAINTENA have had unusual urges such as gambling, binge eating or eating that you cannot control (compulsive), compulsive shopping, and sexual urges.

    If you or your family members notice that you are having unusual urges or behaviors, talk to your healthcare provider.

  • Decreased blood pressure (orthostatic hypotension). You may feel lightheaded or faint when you rise too quickly from a sitting or lying position.
  • Low white blood cell count
  • Seizures (convulsions)
  • Problems controlling your body temperature so that you feel too warm. Do not become too hot or dehydrated while you receive ABILIFY MAINTENA. Do not exercise too much. In hot weather, stay inside in a cool place if possible. Stay out of the sun. Do not wear too much clothing or heavy clothing. Drink plenty of water.
  • Difficulty swallowing

Do not drive, operate machinery, or do other dangerous activities until you know how ABILIFY MAINTENA affects you. ABILIFY MAINTENA may make you feel drowsy.

Do not drink alcohol while you receive ABILIFY MAINTENA.

Before receiving ABILIFY MAINTENA, tell your healthcare provider about all your medical conditions, including if you:

  • have never taken aripiprazole before

  • have diabetes or high blood sugar or a family history of diabetes or high blood sugar. Your healthcare provider should check your blood sugar before you start receiving ABILIFY MAINTENA and during your treatment.

  • have or had seizures (convulsions)

  • have or had low or high blood pressure

  • have or had heart problems or a stroke

  • have or had a low white blood cell count

  • have problems that may affect you receiving an injection in your arm or buttocks

  • are pregnant or plan to become pregnant. It is not known if ABILIFY MAINTENA will harm your unborn baby. If you become pregnant while receiving ABILIFY MAINTENA, talk to your healthcare provider about registering with the National Pregnancy Registry for Atypical Antipsychotics. You can register by calling 1-866-961-2388 or go to http://womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/

  • are breastfeeding or plan to breastfeed. ABILIFY MAINTENA can pass into your milk and may harm your baby. Talk to your healthcare provider about the best way to feed your baby if you receive ABILIFY MAINTENA.

Tell your healthcare provider about all the medicines you take, including prescription medicines, over-the-counter medicines, vitamins, and herbal supplements.

ABILIFY MAINTENA and other medicines may affect each other causing possible serious side effects. Do not start or stop any medicines during treatment with ABILIFY MAINTENA without talking to your healthcare provider first.

The most common side effects of ABILIFY MAINTENA include: weight gain, inner sense of restlessness such as feeling like you need to move (akathisia), injection site pain, or sleepiness (sedation).

It is important to contact your healthcare provider if you experience prolonged, abnormal muscle spasms or contractions, which may be signs of a condition called dystonia.

These are not all the possible side effects of ABILIFY MAINTENA.

If you have any questions about your health or medicines, talk to your healthcare provider.

You are encouraged to report side effects of ABILIFY MAINTENA (aripiprazole). Please contact Otsuka America Pharmaceutical, Inc. at 1-800-438-9927 or FDA at 1-800-FDA-1088 (www.fda.gov/medwatch).

INDICATIONS

ABILIFY MAINTENA® (aripiprazole) is a prescription medicine given by injection by a healthcare professional for:

  • treatment of schizophrenia in adults
  • maintenance treatment of bipolar I disorder in adults

It is not known if ABILIFY MAINTENA is safe and effective in children under 18 years of age.

 

Please see FULL PRESCRIBING INFORMATION, including BOXED WARNING, and MEDICATION GUIDE.