*Terms and Conditions
Iroko Cares™ Savings Program Instructions, Terms, and Conditions: This card is valid for eligible patients with commercial insurance. This card may be used to reduce your out-of-pocket cost for 30 or more capsules of VIVLODEX®, ZORVOLEX®, or TIVORBEX®. Patient must be 18 years of age or older to participate in this program. Not valid where third-party payer (including secondary insurance) covers full cost of prescription without patient liability. Redeem this card only when accompanied by a valid prescription for VIVLODEX®, ZORVOLEX®, or TIVORBEX®.
With this card, commercially-insured patients may pay as little as $10, if product is covered by primary insurance. See Terms and Conditions below.
Patients with questions about using the savings card should call 1-888-591-9796.
Pharmacist Instructions for a Patient with Commercial Insurance: Submit the claim to the primary Third Party Payer first, then submit the balance due to Therapy First Plus as a Secondary Payer COB [coordination of benefits] with patient responsibility amount and a valid Other Coverage Code (e.g. 8). Patient may pay as little as $10 if product is covered by primary insurance. Maximum reimbursement limits apply. Reimbursement will be received from Therapy First Plus.
Valid Other Coverage Code Required. Pharmacists, for any questions regarding Therapy First Plus online processing please call the Help Desk at 1-800-422-5604.
The ‘Swirl Design logo’ and SoluMatrix Technology™ are trademarks of iCeutica Pty Ltd., and are licensed to Iroko.
This offer is valid only in the United States. Program is applicable only for commercially-insured patients. Cash discount cards are not commercial payers and are not eligible to be used for this program. Offer not valid for prescriptions reimbursed under Medicaid, a Medicare drug benefit plan (including Part D), Medigap, VA, DOD or Tricare or other federal or state health programs (such as medical assistance programs). If the patient is eligible for benefits under any such program, the patient cannot use this offer. By using this offer, the patient certifies that he or she will comply with any terms of his or her health insurance contract requiring notification to his or her payer of the existence and/or value of this offer. It is illegal to (or offer to) sell, purchase, or trade this offer. This offer is not transferable. Cannot be combined with any other rebate/coupon, free trial, or similar offer for the specified prescription(s). Not valid if reproduced. Void where prohibited by law. Program managed by PSKW, LLC on behalf of Iroko Pharmaceuticals, LLC. The parties reserve the right to rescind, revoke, amend or terminate this offer without written notice at any time.