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I WILL sign up for Lialda prescription savings and support

Information is key to education and helping you feel more empowered to take charge of managing ulcerative colitis (UC). The Lialda Patient Support Program offers prescription savings for eligible patients, tools, and resources designed to help you learn more about Lialda and become more engaged in your treatment plan.

What would you like to sign up for?

  • Lialda Pharmacy
    Savings Card Program

  • Eligible patients may be able to lower their out-of-pocket monthly prescription costs for Lialda, and will be automatically enrolled in the Lialda Patient Support Program.

    You can even have text alerts and refill reminders sent to your mobile phone (message and data rates may apply).

    Click ‘continue’ below to sign up.

  • Patient Communications
     

  • Information designed to help you learn more about Lialda, delivered to you.

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     Mail

With the Lialda Pharmacy Savings Card, eligible commercially insured patients pay the first $10 per monthly supply. After paying the first $10, the maximum savings is up to $500 for the first three monthly fills and $120 per monthly fill for the remainder of 2017. Eligible cash-paying patients receive up to a $50 savings on the cost of their monthly prescription and will generally pay more than $10. Patients with questions, please call 1-866-250-8840.

You must be 18 years or older to participate. Only valid on one prescription per month at participating US pharmacies. Offer not valid for prescriptions covered by or submitted for reimbursement under Medicaid, a Medicare drug benefit plan, Tricare, or other federal or state health programs (including any state medical assistance program). By using this offer, you certify that you are ineligible for prescription drug benefits under any such program and that you will comply with all terms of your health insurance contract requiring payer notification of the existence and/or value of this offer. Program managed by PSKW, LLC on behalf of Shire US Inc. The parties reserve the right to amend or end this program at any time. Card not valid if reproduced and may not be redeemed for cash. Void where prohibited by law. This offer is not transferrable and is limited to one offer per person. Card expires on 12/31/17. Other restrictions may apply.

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Contact Information

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Lialda Pharmacy Savings Card Program Eligibility Check

We need to verify that you are eligible for the Lialda Pharmacy Savings Card. Please fill in the information below. Items marked with (*) are required.

  • Yes No
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Sign Up For Text Alerts

  • Terms and Conditions and Additional Information

    To help you stay on top of your Lialda prescription, we’ll text confirmation of your out-of-pocket savings and refill reminders to your mobile phone. You can also receive your card ID information via text. We’ll also text you to see if you want us to send refill requests directly to your pharmacy.

    By providing your mobile phone number you are consenting to receive these periodic text messages. Shire’s partner(s) will use pharmacy claim information associated with your participation in the Lialda Pharmacy Savings Card Program in order to send you these messages. Message and data rates may apply. You may opt out of receiving messages by texting the keyword "STOP" at any time. For help, text the keyword “Help”. You represent that you are the authorized user of the wireless device you use to receive the messages and that you are authorized to approve any charges. Shire reserves the right to alter these terms and conditions or discontinue the messaging at any time and at its sole discretion, may add or delete a cellular carrier from this program at any time, without notice. Text messages you receive as part of this program are automated and your responses are not read by any person. This consent will be in effect until you opt out of receiving these communications from Shire. Please see our Privacy Policy for additional information.

Address Information

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Tell me more

We require this information in order to send you communications by US postal mail related to this program.

Mail-order pharmacy patients
Most mail-order pharmacies require patients to send a photocopy of their Lialda Pharmacy Savings Card along with their prescription. If the mail-order pharmacy does not accept the Lialda Pharmacy Savings Card, please call 1-866-250-8840 for assistance. Valid only if patient's out-of-pocket costs are more than the discount provided by the program.

  • Yes No
  • You are enrolling in the Lialda Pharmacy Savings Card Program and certifying that you are at least 18 years of age, are a resident of the US, and that you are ineligible for prescription drug benefits under Medicaid, a Medicare drug benefit, Tricare, or other federal or state health programs (including any state medical assistance program). If you are a commercially insured patientRead More


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