^eThe HYRIMOZ^® Patient Transition Program provides a one-time reimbursement of costs to patients who transition from Humira^® to HYRIMOZ, in the form of a $200 debit card that the patient must certify will be used for healthcare-related expenses. The following are acceptable merchant codes at which the debit cards can be used: 5912 DRUG STORES, PHARMACIES; 8011 DOCTORS – NOT ELSEWHERE CLASSIFIED; 8050 NURSING AND PERSONAL CARE FACILITIES; 8062 HOSPITALS; 8071 DENTAL AND MEDICAL LABORATORIES; and 8099 HEALTH PRACTITIONERS/MED SVCS UNCLASSIFIED. To qualify, a patient must provide proof of a filled HYRIMOZ prescription for an approved indication dated no more than 90 days prior to applying for the Patient Transition Program. Residents of Illinois, Massachusetts, Michigan, Minnesota, Mississippi, and Rhode Island are not eligible. A patient is not eligible if the patient’s prescription is paid for, in whole or in part, by any state or federally funded programs, including but not limited to Medicare (including Part D, even in the coverage gap) or Medicaid, Medigap, VA, DOD, or TRICARE, or private indemnity, or HMO insurance plans that reimburse the patient for the entire cost of the patient’s prescription drugs, or where prohibited by law. Sandoz reserves the right to rescind, revoke, or amend this offer at any time and without further notice.

^fMessage and data rates may apply.

^gSandoz HYRIMOZ Co-Pay Terms and Conditions: Limitations apply. Valid only for patients with private insurance and where not prohibited by law. Prescription must be for an approved indication. Program is subject to an annual limit, and the patient is responsible for any costs once limit is reached in a calendar year. Program not valid (i) under Medicare, Medicaid, TRICARE, VA, DoD, or any other federal or state health care program, (ii) where patient is not using insurance coverage at all, (iii) where the patient's insurance plan reimburses for the entire cost of the drug, or (iv) where product is not covered by patient's insurance. The value of this program is exclusively for the benefit of patients and is intended to be credited towards patient out-of-pocket obligations and maximums, including applicable co-payments, coinsurance, and deductibles. Patient may not seek reimbursement for the value received from this program from other parties, including any health insurance program or plan, flexible spending account, or health care savings account. Patient is responsible for complying with any applicable limitations and requirements of their health plan related to the use of the Program. Valid only in the United States and US Territories (Puerto Rico, American Samoa, Guam, Northern Mariana Islands, and US Virgin Islands). This Program is not health insurance, and may not be combined with any third-party rebate, coupon, or offer. Proof of purchase may be required. Sandoz reserves the right to rescind, revoke, or amend the Program and discontinue support at any time without notice.

Cordavis HYRIMOZ Co-Pay Terms and Conditions: Limitations apply. Valid only for those with private insurance. Prescription must be for an approved indication. Patient is responsible for any costs once limit is reached in a calendar year. Program not valid (i) under Medicare, Medicaid, TRICARE, VA, DoD, or any other federal or state health care program, (ii) where patient is not using insurance coverage at all, (iii) where the patient's insurance plan reimburses for the entire cost of the drug, or (iv) where product is not covered by patient's insurance. The value of this program is exclusively for the benefit of patients and is intended to be credited towards patient out-of-pocket obligations and maximums, including applicable co-payments, coinsurance, and deductibles.

The HYRIMOZ^® Co-pay Terms and Conditions have restrictions when insurance entities limit what can be counted towards your deductible or other costs you bear when buying your medication. The most common names are “co-pay accumulator” or “co-pay maximizer” programs. These programs may be implemented without your awareness. In some cases, there may be a negative financial impact. The use of “co-pay accumulator” or “co-pay maximizer” programs by your insurer or health plan will limit your program benefits. These limits can be modified without prior notice. Cordavis reserves the right to audit and investigate any suspected violation of these terms and conditions. Cordavis also has the right to modify these terms and conditions at any time without prior notice.

Program is not valid where prohibited by law. Patient may not seek reimbursement for the value received from this Program from other parties, including any health insurance program or plan, flexible spending account, or health care savings account. Patient is responsible for complying with any applicable limitations and requirements of their health plan related to the use of the Program. Valid only in the United States and US Territories (Puerto Rico, Guam, Northern Mariana Islands, and Virgin Islands). This Program is not health insurance. Program may not be combined with any third-party rebate, coupon, or offer. Proof of purchase may be required. Cordavis reserves the right to rescind, revoke, or amend the Program and discontinue support at any time without notice.