These Terms and Conditions are valid for YUFLYMA as of the date published until amended or terminated by Celltrion CARES™ (“Program Period”). As a condition of participation in the Program, participants understand and agree that Celltrion may, in its sole discretion, limit, rescind, revoke, terminate, or amend the Program at any time, for any reason, without notice. It is the responsibility of participants to review these Terms and Conditions each time before relying on any Program benefits.
The Celltrion CARESTM Co-pay Assistance Program (“Program”) seeks to help Eligible Patients (defined below) with certain out-of-pocket costs for YUFLYMA® (adalimumab-aaty). Under the Program, Eligible Patients may pay as little as $0 for YUFLYMA each time they present their Co-pay Card to fill their prescription. The Program is subject to certain limitations set out below, including Qualifying Expenses (defined below), maximum limits, available funding, and patient eligibility requirements or other restrictions. Actual per prescription savings for Qualifying Expenses may vary, and patients may be responsible for out-of-pocket costs not covered under this Program.
To qualify for Program benefits, the patient must meet the following eligibility requirements (“Eligible Patients”):
- Have Commercial Insurance: Patient must have and use private/commercial health insurance that provides at least some coverage for YUFLYMA® (adalimumab-aaty). Patients who do not have coverage for YUFLYMA or do not elect to use their commercial health plan to cover at least some of the cost of YUFLYMA are ineligible for the Program. Additionally, patients are ineligible for the Program where their insurance policy prohibits such co-pay assistance programs. It is the patient’s responsibility to check with their insurance carrier to confirm that their participation in the Program is not inconsistent with insurance carrier’s requirements; including satisfying any conditions imposed by their carrier for participation in the Program.
- No Federal or State Health Insurance: Patients are ineligible for the Program if they are covered, in whole or in part, under:
- Medicaid (including Medicaid patients enrolled in a qualified health plan purchased through a health insurance exchange marketplace established by a state government or the federal government),
- Medicare (Part A or B),
- Medicare Part D or Medicare Advantage plan (regardless of whether a specific prescription is covered),
- TRICARE, Veterans Affairs healthcare or the Civilian Health and Medical Program (CHAMPVA),
- Puerto Rico Government Health Insurance Plan (“Healthcare Reform” formerly known as “La Reforma de Salud”),
- A State prescription drug assistance program, or
- Any other state or federal medical or pharmaceutical benefit program or pharmaceutical assistance program (collectively, “Government Programs”).
If at any time in the future, a patient begins receiving prescription drug coverage for YUFLYMA under any such Government Program(s), the patient is ineligible for the Program and must call Celltrion CARESTM at 1-877-81CONNC (1-877-812-6662) to stop participation in the Program immediately.
- No Self-Pay: The Program is not valid for self-pay or cash-paying patients (i.e., patients without commercial health insurance, patients with health insurance who lack coverage for YUFLYMA, or patients who do not seek to use commercial health insurance to pay for YUFLYMA under their plan).
- Residency & Age: Patient must be a resident of the United States or the Commonwealth of Puerto Rico and must be 18 years or older (or have a caregiver or legal guardian duly authorized to provide legal consent to these Terms and Conditions on behalf of the patient). Additionally, YUFLYMA covered under the Program must originate, be administered to the patient, and shipped to locations in the United States or the Commonwealth of Puerto Rico.
- On-label Prescription: Patient must be under the care of a physician and prescribed YUFLYMA for one of the following FDA-approved indications:
- Rheumatoid Arthritis (RA): reducing signs and symptoms, inducing major clinical response, inhibiting the progression of structural damage, and improving physical function in adult patients with moderately to severely active RA.
- Juvenile Idiopathic Arthritis (JIA): reducing signs and symptoms of moderately to severely active polyarticular JIA in patients 2 years of age and older.
- Psoriatic Arthritis (PsA): reducing signs and symptoms, inhibiting the progression of structural damage, and improving physical function in adult patients with active PsA.
- Ankylosing Spondylitis (AS): reducing signs and symptoms in adult patients with active AS.
- Crohn’s Disease (CD): treatment of moderately to severely active Crohn’s disease in adults and pediatric patients 6 years of age and older.
- Ulcerative Colitis (UC): treatment of moderately to severely active ulcerative colitis in adults. Limitations of Use: Effectiveness has not been established in patients who have lost response to or were intolerant to tumor necrosis factor (TNF) blockers.
- Plaque Psoriasis (Ps): treatment of adult patients with moderate to severe chronic plaque psoriasis who are candidates for systemic therapy or phototherapy, and when other systemic therapies are medically less appropriate.
- Hidradenitis Suppurativa (HS): treatment of adult patients with moderate to severe hidradenitis suppurativa.