EPRONTIA IVA

References

1. EPRONTIA [package insert]. Wilmington, MA: Azurity Pharmaceuticals, Inc.; 2021.

2. US Food and Drug Administration. Report: limited FDA survey of compounded drug products. https://www.fda.gov/drugs/human-drug-compounding/report-limited-fda-survey-compounded-drug-products. Accessed December 14, 2021.

3. Current Good Manufacturing Practice (CGMP) guidelines. US Food and Drug Administration website. https://www.fda.gov/drugs/pharmaceutical-quality-resources/current-good-manufacturing-practice-cgmp-regulations. Accessed November 18, 2021.

4. Institute for Safe Medication Practices. List of oral dosage forms that should not be crushed. https://www.ismp.org/recommendations/do-not-crush. Published February 21, 2020. Accessed November 18, 2021.

5. TOPAMAX® (topiramate) Dosing - Crushing Tablets and Special Administration: Suspension, NG tube, and Rectal. https://www.janssenmd.com/topamax/dosage-and-administration/administration-routes/topamax-dosing-crushing-tablets-and-special-administration-suspensionng-tube-and-rectal. Accessed December 16, 2021.

6. McGrady ME, Hommel KA. Medication adherence and health care utilization in pediatric chronic illness: a systematic review. Pediatrics. 2013;132(4):730-740.

7. Gutierrez-Colina AM, Smith AW, Mara CA, Modi AC. Adherence barriers in pediatric epilepsy: from toddlers to young adults. Epilepsy Behav. 2018;80:229-234.

8. Chappell F. Medication adherence in children remains a challenge. Prescriber. 2015;26(12):31-34.

9. Polaha J, Dalton WT 3rd, Lancaster BM. Parental report of medication acceptance among youth: implications for everyday practice. South Med J. 2008;101(11):1106-1112. doi:10.1097/smj.0b013e318180645d

10. Gibbs SN, Choi J, Khilfeh I, Ahmed KH, Yermilov I, Segal E. The humanistic and economic burden of pediatric focal seizures in the United States. J Child Neurol. 2020;35(8):543-555. doi:10.1177/0883073820911785

11. Data on file. Azurity Pharmaceuticals, Inc.

*Eligibility Restrictions, Terms, and Conditions

By participating in this savings program, participants understand and agree that the information provided, as well as non-personally identifiable information obtained from the pharmacy, will be shared with the manufacturer and with any companies working with the manufacturer. Participants also affirm that they will not submit, and have not had submitted on their behalf, a claim for reimbursement or coverage for items purchased with this card under Medicaid, Medicare, TRICARE, or any other federal or state government healthcare program, or where prohibited by state law.

Out-of-pocket expenses will be covered up to $250 per 30-day prescription. You will be responsible for any additional out-of-pocket amount over $250. Example: If your out-of-pocket expense is $45, you will pay nothing for the 30-day prescription. If your out-of-pocket expense is $300, you will be responsible for $50.
Offer applies only to EPRONTIA™ patients and associated refills
This offer is not valid for prescriptions paid in part or in full by any federally or state-funded program, including but not limited to Medicaid, Medicare, Department of Veterans Affairs, Department of Defense, or TRICARE, and where prohibited by law.
This savings program cannot be combined with any other coupon, certificate, voucher, or similar offer.
Offer good only in the USA at participating retail pharmacies and cannot be redeemed at government-subsidized clinics. Void where taxed, restricted, or prohibited by law.
Offer not extended to clubs, groups, or organizations.
Participation in this program must comply with all applicable laws and contractual or other obligations as a pharmacy provider. This is not an insurance program.
Participating patients and pharmacists understand and agree to comply with the Terms and Conditions of this offer as set forth herein.
Any step-edits or prior authorizations required by the insurance plan still apply.
Azurity Pharmaceuticals, Inc. reserves the right to modify or cancel this program at any time.
eVoucherRx™ and Voucher on Demand™ are not extended on prescriptions for patients:
- who are cash-paying customers.
- using institution-based pharmacies to fill their prescriptions, or who are recipients of federal or state government health care.
- who are filling their prescriptions at nonparticipating pharmacies.

eVoucherRx™ is a trademark of RelayHealth.
Voucher on Demand™ is a trademark of eRx Network, LLC.

^$0 co-pay

EPRONTIA™ is accessible for your patients*