rocklatan patient assistance program

This offer may not be redeemed for cash. Other common side effects were pain upon instillation of eye drop (20%), small deposits on the outer surface of the eye (corneal verticillata) (15%), and broken blood vessels (11%). This reaction did not result in any apparent visual functional changes. Netarsudil works by restoring aqueous outflow through the trabecular meshwork, while latanoprost increases outflow . Select below for other countries. Avoid allowing the tip of the bottle to touch the eye to avoid bacterial eye infection which has been reported with the use of multiple-dose containers of topical ophthalmic products. Use with caution in aphakic patients, pseudophakic patients with a torn posterior lens capsule, or patients with known risk factors for macular edema. Managed Markets Insight & Technology, LLC. The following table lists the phone numbers of pharmaceutical companies to call to inquire about potential glaucoma medication financial assistance. Patient pay amount may vary dependent upon commercial insurance coverage for ROCKLATAN or RHOPRESSA. Alcon reserves the right to rescind, revoke, or amend the Program and discontinue support at any time without notice. ROCKLATAN (netarsudil and latanoprost ophthalmic solution) 0.02%/0.005% is supplied sterile in clear low density polyethylene bottles with opaque white polyethylene dropper tips and white polypropylene screw caps. Rocklatan prices starting at $375.30. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. call 844-807-9706 or visit the program website. Revised: 03/2019 . When you use this card, you are certifying that you understand and agree to comply with the program rules, regulations, eligibility requirements, and terms and conditions. Financial Aid for Glaucoma Medications Fact Sheet Published on: August 24, 2021 Learn about financial aid resources that may be available to help cover the costs of your glaucoma prescription medications. Program managed by ConnectiveRx on behalf of Aerie Pharmaceuticals, Inc. Aerie Pharmaceuticals, Inc. reserves the right to rescind, revoke or amend this offer without notice at any time. Pharmacist instructions: Submit the claim to the primary commercial insurance company first, then submit the balance due to CHANGE HEALTHCARE as a Secondary Payer COB with patient responsibility amount and a valid Other Coverage Code (OCC). Argentina Usually reversible upon discontinuation of treatment. JWe=I)a)PRQd Bacterial keratitis has been reported with multiple-dose containers of topical ophthalmic products inadvertently contaminated by patients. Patients with questions about the ROCKLATAN or RHOPRESSA Savings offer should call 1-844-807-9706. Be sure to contact your doctor if you have any questions. Here are 10 ways to save money on prescription drugs. Eye itching, visual acuity reduced, excessive tearing, eye discomfort upon administration of eye drop, and blurred vision were reported in 5-8% of patients. If you have limited or no prescription insurance coverage or are experiencing financial hardship, Alcon Cares provides medicines at no cost to eligible US patients: Prescription medications: Simbrinza, Eysuvis, and Inveltys. Patient assistance programs (PAPs) help people with no health insurance and those who are underinsured afford medications. Increased pigmentation of the iris, periorbital tissue (eyelid), and eyelashes can occur. Rocklatan contains latanoprost, which may cause darkening of the eye color, darkening of the eyelid and eyelashes, and increased growth and thickness of eyelashes. By using this offer, you are certifying that you meet the eligibility criteria and will comply with the terms and conditions described in the Restrictions section below. Ecuador These are some questions to ask when you talk to your eye doctor about Rocklatan. Program may not be combined with any third-party rebate, coupon, or offer. 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 Instructions: In order to redeem this offer you must have a valid prescription for ROCKLATAN or RHOPRESSA. Receive Glaucomaresearch updates and inspiring stories. The most common side effect for Rocklatan in controlled clinical studies were red eyes (59%). No cash back. This site is intended for US healthcare professionals only. Void where prohibited by law. These programs are managed by pharmaceutical companies, nonprofits, and government agencies. The most common ocular adverse reactions were conjunctival hyperemia (59%), with 5% of patients discontinuing therapy for this reason, instillation site pain (20%), corneal verticillata (15%), and conjunctival hemorrhage (11%). Proof of purchase may be required. Glaucoma Medications (On mobile devices, swipe left to see all of the table columns.) Restrictions apply. What you may experience from one powerful drop of Rocklatan Rocklatan is different. Rocklatan isn't available in a generic form. Patient assistance programs (PAPs) are typically sponsored by pharmaceutical companies and offer cost-free or discounted medicines, See full prescribing information . This offer is good only in the United States of America and Puerto Rico. Rocklatan (netarsudil/latanoprost ophthalmic solution) For the reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension Reach for Rocklatan for powerful IOP reduction Rocklatan has been acquired by Alcon, the Global Leader in Eye Care. Generic version. Financial and insurance assistance. For patients with commercial insurance, the Alcon Patient Access Program may be able to help lower the cost of their monthly copay. Storage: Protect from light. Rhopressa (netarsudil ophthalmic solution) 0.02% is indicated for the reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension. Would a once-daily prescription eye medication like Rocklatan, What is my eye pressure goal or target IOP? This offer is not transferable. ROCKLATAN (netarsudil and latanoprost) SELF ADMINISTRATION Indications for Prior Authorization: Indicated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension Patients must meet the following criteria for the indication (s) above: Patient is 18 years of age or older, AND 11 DESCRIPTION Avoid use in cases of active herpes simplex keratitis. It is illegal to (or offer to) sell, purchase, trade, reproduce or counterfeit this offer. Rocklatan may cause macular edema (swelling of the macula) and should be used with caution in patients without a natural lens, in patients with a torn posterior lens capsule who have an artificial lens implant, or in patients with known risk factors for macular edema. [see Patient Counseling Information (17)]. This offer will expire on March 1, 2023. -p Available for Android and iOS devices. Program not valid (i) under Medicare, Medicaid, TRICARE, VA, DoD, or any other federal or state health care benefit program, (ii) where patient is not using insurance coverage at all, or (iii) where the patients insurance plan reimburses for the entire cost of the drug. Eligible commercially insured patients may pay as little as $25 per 30-day, 60-day, or 90-day supply. For the reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocularhypertension, Rocklatan has been acquired by Alcon, the Global Leader in Eye Care. Europe / Middle East / Africa This offer is not valid with other offers. Use with caution in aphakic patients, pseudophakic patients with a torn posterior lens capsule, or patients with known risk factors for macular edema. Phone: 1-800-222-6885 Fax: 1-866-898-1473 Upon review of a completed application, we will notify the patient and the prescriber about eligibility. Looking to reduce costs at the pharmacy counter? See full prescribing information for ROCKLATAN. If you have eye surgery, eye trauma or infection, or develop any eye reactions, immediately consult with your physician about continuing treatment with Rocklatan. ROCKLATAN (netarsudil and latanoprost ophthalmic solution) 0.02%/0.005% is indicated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension. For adults with open-angle glaucoma or ocular hypertension, Thats less than $9 per month for a 90-dayprescription. Managed Market Insights & Technology, LLC. Note: This is a drug discount program, not an insurance plan. For any questions regarding CHANGE HEALTHCARE online processing, please call the Help Desk at 1-800-433-4893. Other common side effects were pain upon instillation of eye drop (20%), small deposits on the outer surface of the eye (corneal verticillata) (15%), and broken blood vessels (11%). Please call 1-800-222-6885 to request refills. ROCKLATAN (netarsudil and latanoprost ophthalmic solution) . For any questions regarding CHANGE HEALTHCARE online processing, please call the Help Desk 1-800-433-4893. Eyelash changes are usually reversible upon discontinuation of treatment. If one dose is missed, treatment should continue with the next dose in the evening. Offer valid up to 12-month qualifying prescriptions. EXISTING EYEFILE USER? Avoid use in cases of active herpes simplex keratitis. Many times however, the offers listed on rxless will be less expensive than manufacturer coupons, copay cards, or patient assistance programs - so make sure you compare all options before making a purchase. This offer is void in U.S. territories including, but not limited to, Puerto Rico. Should generally not be used in patients with active intraocular inflammation. BY USING THIS CARD, YOU AND YOUR PHARMACIST UNDERSTAND AND AGREE TO COMPLY WITH THESE ELIGIBILITY REQUIREMENTS AND TERMS OF USE. Over the counter medications, such as Systane and Pataday. Chile Patients with questions about the ROCKLATAN or RHOPRESSA Savings offer should call 1-844-807-9706. This is a copay assistance program: Provided by: Patient Access Network Foundation: TEL: 866-316-7263 FAX: 866-316-7261: Languages Spoken: English, Spanish, Others By Translation Service. Eyelash changes are usually reversible upon discontinuation of treatment. If more than one topical ophthalmic drug is being used, the drugs should be administered at least five (5) minutes apart. Your medicine matters. Iris pigmentation likely to be permanent. copay assistance programs, or by persons covered by state-funded or federal-funded programs such as Medicare, Medicaid, or Tricare for purchases of certain medications, even if processed outside the benefit as an uninsured (cash-paying . Avoid allowing the tip of the bottle to touch the eye to avoid bacterial eye infection which has been reported with the use of multiple-dose containers of topical ophthalmic products. ROCKLATAN safely and effectively. Contact lenses should be removed prior to using Rocklatan. Applies to: Rocklatan Number of uses: Per prescription per calendar year Expires December 31, 2023 To qualify for a financial assistance program, you (or the patient you're applying for) must: Be getting treatment for the disease named in the assistance program, and. Download the Rhopressa Savings Card and instruct patients to present it to the pharmacist with their prescription. These forms may be used to initiate an appeal on a patient's behalf or request an enrolled patient's next product shipment. Rocklatan should be used with caution and may cause inflammation inside the eye or make existing inflammation worse. Spain Learn More about Alcon's Glaucoma Product Portfolio Learn about Rocklatan including its uses, possible side effects, interactions, images, warnings and similar drugs. Other common (approximately 20%) adverse reactions were: corneal verticillata, instillation site pain, and conjunctival hemorrhage. Rocklatan is covered for over 80% of insured patients You can save even more on your prescription with the Rocklatan Savings Card 30-day supply $ 25 per month 90-day supply $ 8 .33 per month That's less than $9 per month for a 90-day prescription IMPORTANT SAFETY INFORMATION Contraindications None. Rocklatan (netarsudil / latanoprost) contains a prostaglandin, which can darken the color of your eyes, eyelids, and eyelashes. BrightFocus is a tax-exempt nonprofit organization under section 501(c)(3) of the Internal Revenue Code of the United States. (On mobile devices, swipe left to see all of the table columns.). Five percent of patients discontinued therapy due to red eyes. We comply with the HONcode standard for trustworthy health information. Rocklatan offers may take the form of printable coupons, rebates, savings or copay cards, trial offers, or free samples. Restrictions: This offer is valid for eligible residents of the United States only. Use with caution in patients with a history of intraocular inflammation (iritis/uveitis). For eligible commercial patients when the product is not covered, submit BIN and OCC 03. Patients who are enrolled in a state or federally funded prescription insurance program, such as Medicare or Medicaid, are excluded. Alcon is committed to supporting patient access to medications. Prescription assistance can be offered in the way of Patient Assistance Programs (PAPs), which are created by pharmaceutical companies to provide free or discounted medicines to people who are unable to afford them. Rx Assist allows for digital transformation to help maximize prescription volume, adherence, loyalty, and return. Quoted prices are for cash-paying customers and are not valid with insurance plans. Offer not valid for patients under 18 years of age. Maximum savings limit applies; patient out-of-pocket expense may vary. Avoid allowing the tip of the bottle to touch the eye to avoid bacterial eye infection which has been reported with the use of multiple-dose containers of topical ophthalmic products. Delivering Confidence in Glaucoma Management With its acquisition of Aerie Pharmaceuticals, Alcon has bolstered its presence in the ophthalmic pharmaceutical space including expanding its product portfolio for glaucoma management. Patients who are enrolled in a state or federally funded prescription insurance program, such as Medicare or Medicaid, are excluded. Five percent of patients discontinued therapy due to red eyes. You must be 18 years of age or older to redeem this offer for yourself or as a caregiver. You are encouraged to report negative side effects of prescription drugs to the FDA. This offer is not valid for any person who is 65 years of age or older without commercial insurance. 3c1Z lBC bak& We recently rebranded to MyAlcon. Order Online > Prior Authorization Support Online tools to help prescribers navigate the PA and medical necessity process. 698 0 obj <>stream Accessed on April 18, 2022. No Patient Assistance Programs were found for this medication. Contact lenses can be reinserted 15 minutes following administration of Rocklatan. Most corneal verticillata resolved upon discontinuation of treatment. It works by increasing the flow of fluids out of the eye, which helps lower pressure in the eye. Contact Lenses: Contact lenses should be removed prior to instillation of Rhopressa and may be inserted 15 minutes following its administration. as well as copay programs, to individuals with low income or those who are uninsured/under-insured and meet specific criteria. Patient pay amount may vary dependent upon commercial insurance coverage for ROCKLATAN or RHOPRESSA. See 17 for PATIENT COUNSELING INFORMATION . DOSAGE AND ADMINISTRATION The recommended dosage is one drop in the affected eye (s) once daily in the evening. Rocklatan should be used with caution and may cause inflammation inside the eye or make existing inflammation worse. Eye itching, visual acuity reduced, excessive tearing, eye discomfort upon administration of eye drop, and blurred vision were reported in 5-8% of patients. Support Page For Rocklatan Back Rocklatan Website Prescribing Information Click on an icon below for additional resources that can be found for this drug. Eligibility is based on several factors, including income limits that are . Please re-register using the form here. PeopleImages/iStock via Getty Images. For patients with private insurance, the Alcon Patient Access Program may be able to help lower your out-of-pocket cost for these prescription products: For patients with Medicare Part D or Medicare Advantage insurance, Alcon may be able to help with the cost of your Inveltys prescription with use of a $60 coupon. The most common side effect for Rocklatan in controlled clinical studies were red eyes (59%). 8.2 Lactation . This site is intended for US healthcare professionals only. Until opened, store at 2C to 8C (36F to 46F). To download the forms, click on "Forms & Resources" and then on "Downloads". Other common side effects were pain upon instillation of eye drop (20%), small deposits on the outer surface of the eye (corneal verticillata) (15%), and broken blood vessels (11%). The dosage of ROCKLATAN should not exceed once daily. Valid only for those with private insurance. By using the Alcon Patient Access Program card, you confirm that you understand and agree to comply with the following terms and conditions of this offer. Use with caution in patients with a history of herpetic keratitis. The most common ocular adverse reaction observed in controlled clinical studies with Rhopressa dosed once daily was conjunctival hyperemia, reported in 53% of patients. 8.4 Pediatric Use . We offer a range of programs to make it easier for patients to obtain their medication. Certain offers may be printable from a website while others may require registration, completing a questionnaire, or obtaining Eye pruritus, visual acuity reduced, increased lacrimation, instillation site discomfort, and blurred vision were reported in 5-8% of patients. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit website. Please click here for full prescribing information for Rocklatan. Rocklatan should be used with caution and may cause inflammation inside the eye or make existing inflammation worse. Copyright 2000 - 2023 BrightFocus Foundation. Rocklatan is available as a brand name drug only, a generic version is not yet available. Patient Instructions: In order to redeem this offer you must have a valid prescription for ROCKLATAN or RHOPRESSA. Most products may be shipped to the patient's home on request. Valid at all major chains including Walgreens, CVS Pharmacy, Rocklatan should be used with caution in patients with a history of herpetic keratitis and not used in patients with active herpes simplex keratitis. Patients with federal or state prescription coverage, such as Medicare or Medicaid, are not eligible. Six percent of patients discontinued therapy due to conjunctival hyperemia. Bacterial Keratitis: There have been reports of bacterial keratitis associated with the use of multiple-dose containers of topical ophthalmic products. Please click here for full prescribing information for ROCKLATAN Solution. Color changes may increase as long as Rocklatan is administered, and eye color changes are likely to be permanent. |ouWvaoTWhF%v6*/{W;VQ?Kx5!7 $%=T?2xK~mz cHki/~"a$j3_(O)+fyll7~h3gL"IJuMbOHZiLaJOJ;U&4,*00 MJr-B=V1q%h~b>=z8zBe The refill functionality is currently undergoing system maintenance. ,":fyt%_4Ui3]gN Ut/eLK0[*&C!W!#;al1[1b=&9.wg-Sj*'nQ TNphH]CkJ>]=||Q7K6`h^calm&`l6$x3Y>Bw@F;:G;HkF2]\}5FEvtD`sZ)G,9>NZ[0$-XWl0 q6~yY Gd8N6*z4g&1_I9m-o-=v9vXk[o+$e(CN@$BBmE\T$ Managed Markets Insight & Technology, LLC. is a member of the ophthalmic glaucoma agents drug class and is commonly used for Thats less than $9 per month for a 90-dayprescription. Insured includes Commercial, Medicare Part D, Managed Medicaid, Health Exchanges, and State Medicaid. Rocklatan is used once daily in the evening. Be sure to contact your doctor if you have any questions. Five percent of patients discontinued therapy due to red eyes. Rocklatan Alcon Patient Access Program Card: Eligible commercially insured patients may pay as little as $30per prescription with a maximum savings of $2000 per calendar year; for additional information contact the program at 833-735-0037. Patient Assistance If you have limited or no prescription insurance coverage or are experiencing financial hardship, Alcon Cares provides medicines at no cost to eligible US patients: Prescription medications: Simbrinza, Eysuvis, and Inveltys. Color changes may increase as long as Rocklatan is administered, and eye color changes are likely to be permanent.
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