Terms and Limitations
Offer expires 12/31/2017. Certain limitations apply. Valid only in the United States at participating retail pharmacies and cannot be redeemed at government-subsidized clinics. Offer must be accompanied by a valid prescription for FENTORA® (fentanyl buccal tablet) CII. Void where prohibited by law. No substitutions permitted. Offer not valid for patients eligible for coverage for FENTORA under Medicare (including Medicare Advantage or Part D Prescription Drug Plans), Medicaid, or other public payment programs (e.g., TRICARE, or any state program). Depending upon the nature and terms of your relationship with insurance carriers, you will report offer redemption to the insurance carrier if required. Offer not valid for prescriptions reimbursed in full (including copay) by any third-party payor. Offer cannot be combined with any other voucher, certificate, coupon, rebate, or similar offer. It is illegal for any person to sell, purchase, or trade, or to offer to sell, purchase, or trade or to counterfeit this offer. This is not an insurance program. Teva reserves the right to rescind, revoke, or amend this offer without notice.
Offer not extended on prescriptions for:
- Patients using mail-order or institution-based pharmacies to fill their prescriptions, or who are federal or state government employees
- Patients who are filling their prescriptions at nonparticipating pharmacies
- Patients age 65 and over (due to Medicare eligibility) or under age 18
Additional Terms and Limitations
- Insured patients only
- Prescribing physician and patient must be enrolled in the TIRF REMS Access program
- Minimum supply of 28 tablets per fill
- One card per patient, cash value of this coupon is 1/100 of a cent. Maximum number of card uses per month is five
By redeeming this offer, patients and pharmacists understand and agree to comply with these terms and conditions.
For questions regarding processing, please call the AlphaScrip Pharmacy Help Desk at 1-877-274-3244.