*The Sancuso Patch Guarantee Program is only for commercially insured patients. If you require other reimbursement assistance, please visit www.patientRXsolutions.com as we may be able to help you with other programs.
For up to 4 patches per month and a yearly maximum benefit of $2,970.
If commercial prescription coverage for the Sancuso patch is denied by insurance, the patient will pay the initial $20 for 1 Sancuso Patch/month. Any remaining drug cost will be reduced by Kyowa Kirin, Inc., marketers of Sancuso, up to a total of $495 per month. In no case will the annual benefit exceed $2,970.
Whether its co-insurance, co-pay, high deductible or some other limit, Patient Rx Solutions will work with insurers, prescribers, and you to provide access to the maximum number of medically necessary prescribed patches that you are eligible to receive for $20 out-of-pocket cost.
Monthly benefit Kyowa Kirin pays will count towards your prescription commercial insurance deductible.
References: 1. Sancuso [package insert]. Bridgewater, NJ: ProStrakan, Inc.; 2015.
†This offer is not valid for prescriptions under Medicare (including Medicare Advantage, Part A, B and D Plans), Medicaid, VA, DOD, TRICARE, CHAMPUS, or other federal or state healthcare programs (such as LIS). Kyowa Kirin, Inc., reserves the right to cancel or modify the program at any time. Unless otherwise indicated on submission form, Sancuso will be dispensed through select ASPN network pharmacy partners; available at participating pharmacies. This offer is not valid for prescriptions in Massachusetts or in any other state that does not permit copay reimbursement consistent with this program. Patients without commercial insurance are not eligible for this program. Offer expires January 31, 2017
SANCUSO® (Granisetron Transdermal System) is indicated for the prevention of nausea and vomiting in patients receiving moderately and/or highly emetogenic chemotherapy regimens of up to 5 consecutive days duration.
IMPORTANT SAFETY INFORMATION FOR PATIENTS
Who should not use Sancuso?
What should I tell my healthcare provider before using Sancuso?
How should Sancuso be used?
Use Sancuso exactly as prescribed. See the detailed Patient Instructions for Applying Sancuso in the Patient Information leaflet.
What should I avoid while using Sancuso?
What are the possible side effects of Sancuso?
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