Approved Use

Repatha® is an injectable prescription medicine used:

  • in adults with cardiovascular disease to reduce the risk of heart attack, stroke, and certain types of heart surgery. READ MORE
  • along with diet alone or together with other cholesterol-lowering medicines in adults with high blood cholesterol levels called primary hyperlipidemia (including a type of high cholesterol called heterozygous familial hypercholesterolemia [HeFH]) to reduce low-density lipoprotein (LDL) or bad cholesterol.
For adults with heart disease
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REPATHA® (evolocumab)
CO-PAY CARD TERMS & CONDITIONS

SUMMARY OF TERMS AND CONDITIONS

It is important that every patient read and understand the full Repatha® Co-pay Card Terms and Conditions. The following summary is not a substitute for reviewing the Terms and Conditions in their entirety.

As further described below, in general:

  • The Repatha® Co-pay Card is open to patients with commercial insurance, regardless of financial need. The
    program is not valid for patients whose Repatha® prescription is paid for in whole or in part by Medicare, Medicaid,
    or any other federal or state healthcare program. It is not valid for cash-paying patients or where prohibited by law.
    (See ELIGIBILITY section below.)
  • With the Repatha® Co-pay Card, a commercially insured patient who meets eligibility criteria may pay as little as a
    $5 co-pay per month for their Repatha® monthly out-of-pocket costs. Monthly out-of-pocket costs include co-
    payment, co-insurance, and deductible out-of-pocket costs. Amgen will pay the remaining eligible out-of-pocket
    costs on behalf of the patient up to a Maximum Monthly Benefit, a Maximum Annual Program Benefit and/or the
    Patient Total Program Benefit. Patients are responsible for all amounts that exceed these limits. (See PROGRAM
    DETAILS section below.)
  • Offer is subject to change or discontinuation without notice.
  • The Repatha® Co-Pay Card provides support up to the Maximum Monthly Benefit, the Maximum Annual Program
    Benefit and/or Patient Total Program Benefit. If a patient’s commercial insurance plan imposes different or
    additional requirements on patients who receive Repatha® Co-Pay Card benefits, Amgen has the right to reduce or
    eliminate those benefits. Whether you are eligible to receive the Maximum Monthly Benefit, Maximum Program
    Benefit or Patient Total Program Benefit is determined by the type of plan coverage you have. Please ask your
    Amgen® SupportPlus Representative to help you understand eligibility for the Repatha® Co-Pay Card, and whether
    your particular insurance coverage is likely to result in your reaching the Maximum Monthly Benefit, the Maximum
    Annual Program Benefit, or your Patient Total Program Benefit, by calling 1-844-REPATHA (1-844-737-2842).
    (See PROGRAM BENEFITS section below.)
  1. ELIGIBILITY

    Eligibility Criteria: Subject to program limitations and terms and conditions, the Repatha® Co-pay Card is open to patients who have a Repatha® prescription and who have commercial or private insurance, including plans available through state and federal healthcare exchanges. This program helps eligible patients cover out-of-pocket costs related to Repatha®, up to program limits. There is no income requirement to participate in this program.

    This offer is not valid for patients whose Repatha® prescription is paid for in whole or in part by Medicare, Medicaid, or any other federal or state healthcare program. It is not valid for cash-paying patients or where prohibited by law. A patient is considered cash-paying where the patient has no insurance coverage for Repatha® or where the patient has commercial or private insurance but Amgen in its sole discretion determines the patient is effectively uninsured because such coverage does not provide a material level of financial assistance for the cost of a Repatha® prescription. This offer is only valid in the United States, Puerto Rico, and the US territories.

  2. PROGRAM BENEFITS

    The Repatha® Co-pay Card helps provide out-of-pocket support to eligible patients for their Repatha® prescription
    up to program limits. See PROGRAM DETAILS for full description.

    The Repatha® Co-pay Card offer does not cover out-of-pocket costs for any patient whose selected coverage option
    under their commercial insurance plan does not apply Repatha® Co-pay Card payments to satisfy the patient’s co-
    payment, deductible, or co-insurance for Repatha®. Patients with these plan limitations are not eligible for the
    Repatha® Co-pay Card but may be eligible for other needs-based assistance provided by Amgen. These programs are
    often referred to as accumulator adjustment programs. If you believe your commercial insurance plan may have such limitations, please contact Amgen SupportPlus at 1-844-REPATHA (1-844-737-2842).

    The Repatha® Co-pay Card may modify the benefit amount, unilaterally determined by Amgen in its sole discretion,
    to satisfy the out-of-pocket cost-sharing requirement for any patient whose plan or plan agent (including, but not
    limited to, a Pharmacy Benefit Manager (PBM)) requires enrollment in the Repatha® Co-pay Card as a condition of
    the plan or PBM waiving some or all of an otherwise applicable patient out-of-pocket cost-sharing amount. These
    programs are often referred to as co-pay maximizer programs. If you believe your commercial insurance plan may
    have such limitations, please contact Amgen SupportPlus at 1-844-REPATHA (1-844-737-2842).
    Health plans and Pharmacy Benefit Managers are prohibited from enrolling or assisting in the enrollment of patients in the Repatha® Co-pay Card. The patient, or his/her legal representative, must personally enroll in the Repatha® Co-pay Card in order to be eligible for program benefits.

    If at any time a patient begins receiving prescription drug coverage under any federal, state or government
    healthcare program (including but not limited to Medicare, Medicaid, TRICARE, Department of Defense, or Veteran
    Affairs programs), the patient will no longer be able to use this card and they must contact Amgen SupportPlus at
    1-844-REPATHA (1-844-737-2842) to stop their participation in this program.

    Patients may not seek reimbursement for the value received from the Repatha® Co-pay Card from any third-party
    payers, including a flexible spending account or healthcare savings account. Participating in this program means
    that you are ensuring you comply with any required disclosure regarding your participation in the Repatha® Co-pay
    Card of your insurance carrier or Pharmacy Benefit Manager. Restrictions may apply. Offer is subject to change or
    discontinuation without notice. This is not health insurance.

  3. PROGRAM DETAILS

    With the Repatha® Co-pay Card, a commercially insured patient who meets eligibility criteria may pay as little as a
    $5 Co-pay per month for their Repatha® monthly out-of-pocket costs.

    • For all eligible patients, the Repatha® Co-Pay Card offers:
      • A program benefit that covers the patient’s eligible out-of-pocket prescription costs for Repatha®
        (co-pay, deductible, or co-insurance) on behalf of the patient, up to a Maximum Monthly Benefit
        and/or a Maximum Annual Program Benefit.
      • Repatha® patients may pay $5 out of pocket at the first fill and at every refill, and Amgen will pay
        on behalf of the patient the remaining eligible out-of-pocket prescription costs (up to the Patient
        Total Program Benefit described below; Repatha® patients are responsible for all amounts that
        exceed this limit).
    • Maximum Monthly Benefit, Maximum Annual Program Benefit, and/or Patient Total Program Benefit and
      Benefits May Change, End, or Vary without notice.
    • The Maximum Annual Program Benefit must be applied to the Repatha® patient’s out-of-pocket costs (co-pay,
      deductible, or co-insurance).
    • The Patient Total Program Benefit amounts are unilaterally determined by Amgen in its sole discretion and will
      not exceed the Maximum Monthly Benefit or Maximum Annual Program Benefit. The Patient Total Program
      Benefit may be less than the Maximum Monthly Benefit or Maximum Annual Program Benefit, depending on the
      terms of a patient’s prescription drug plan, and may vary among individual patients covered by different plans,
      based on factors determined solely by Amgen, to ensure all programs funds are used for the benefit of the
      patient. Each patient is responsible for costs above the Patient Total Program Benefit amounts. Please ask your
      Amgen SupportPlus Representative to help you understand whether your particular insurance coverage is likely
      to result in your reaching the Maximum Monthly Benefit, Maximum Annual Program Benefit or your Patient Total
      Program Benefit amount by calling 1-844-REPATHA (1-844-737-2842) and follow the prompts.
    • Participating patients are solely responsible for updating Amgen with changes to their prescription health
      insurance including, but not limited to, initiation of insurance provided by the government, the addition of any
      coverage terms that do not apply Repatha® Co-pay Card benefits to reduce a patient’s out-of-pocket costs, such
      as accumulator adjustment benefit design or a co-pay maximization program. Participating patients are
      responsible for providing Amgen with accurate information necessary to determine program eligibility. By
      accepting payments from Amgen made on behalf of participating patients, participating PBMs and Plans
      likewise are responsible for providing Amgen with accurate information regarding patient eligibility.
    • Patients may use the card every time they fill their Repatha® prescription. Benefits reset each calendar year. Re-
      enrollment in the program is required at regular intervals. Patients may continue in the program as long as the
      patient re-enrolls as required by Amgen and continues to meet all of the program’s eligibility requirements during
      participation in the program. Patients can enroll/re-enroll by calling 1-844-REPATHA (1-844-737-2842) or by
      going to Repatha.com/copay.

Important Safety Information

Do not use Repatha® if you are allergic to evolocumab or to any of the ingredients in Repatha®.

Before you start using Repatha®, tell your healthcare provider about all your medical conditions, including if you are allergic to rubber or latex, are pregnant or plan to become pregnant, or are breastfeeding or plan to breastfeed. The needle covers on the single-dose prefilled syringes and the inside of the needle caps on the single-dose prefilled SureClick® autoinjectors contain dry natural rubber. The single-dose Pushtronex® system (on-body infusor with prefilled cartridge) is not made with natural rubber latex.

Tell your healthcare provider or pharmacist about any prescription and over-the-counter medicines, vitamins, or herbal supplements you take.

What are the possible side effects of Repatha®?

Repatha® can cause serious side effects including serious allergic reactions. Stop taking Repatha® and call your healthcare provider or seek emergency help right away if you have any of these symptoms: trouble breathing or swallowing, raised bumps (hives), rash or itching, swelling of the face, lips, tongue, throat or arms.

The most common side effects of Repatha® include: runny nose, sore throat, symptoms of the common cold, flu or flu-like symptoms, back pain, high blood sugar levels (diabetes) and redness, pain, or bruising at the injection site.

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

These are not all the possible side effects of Repatha®. Ask your healthcare provider or pharmacist for more information. Call your healthcare provider for medical advice about side effects.

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

APPROVED USE

What is Repatha®?

Repatha® is an injectable prescription medicine used:

  • in adults with cardiovascular disease to reduce the risk of heart attack, stroke, and certain types of heart surgery.
  • along with diet alone or together with other cholesterol-lowering medicines in adults with high blood cholesterol levels called primary hyperlipidemia (including a type of high cholesterol called heterozygous familial hypercholesterolemia [HeFH]) to reduce low density lipoprotein (LDL) or bad cholesterol.

Please see full Prescribing Information.