Treatment Resources: Tools and Guides for Prescribing JYNARQUE

^†Eligibility Requirements

Patients may be eligible for the Commercial Copay Savings Program for JYNARQUE if:

The patient is insured by commercial insurance and the prescription insurance coverage does not cover the full cost of the patient’s JYNARQUE prescription; AND

1. The patient is not covered by a state or federal healthcare program, including but not limited to Medicare Part D, Medicaid (including Medicaid managed care), Medigap, Veterans Affairs (VA), or Department of Defense (DOD) or TRICARE programs; AND
2. The patient is 18 years of age or older; AND
3. The patient is a resident of the United States or Puerto Rico; AND
4. The patient has a prescription consistent with FDA-approved product labeling

Commercial Copay Savings Program Terms & Conditions:

1. Eligible patients who have an activated Member Number under the Commercial Copay Savings Program, together with a valid prescription for JYNARQUE, may pay as little as $0 per 28-day supply of JYNARQUE. Benefit amount is subject to (1) a monthly maximum based on typical insurance reimbursement rates, including maximum annual out-of-pocket limits established by the Affordability Care Act, and (2) a separate annual maximum benefit of the Affordable Care Act Maximum Out-of-pocket ($9,200 for 2025). These maximums are set and may be changed at Otsuka’s sole discretion. Maximum benefits and copay assistance redemption methods may vary as necessary to ensure compliance with these Terms and Conditions. Other restrictions may apply.
2. Offer not applicable to copays of $0 or less.
3. This offer is non-transferable, no substitutions are permissible, and this offer is intended solely for the patient’s benefit and cannot be combined with any other rebate/coupon, free trial, or other offer for the specified prescription (including any pharmacy benefit manager or insurer program that adjusts patients’ out-of-pocket costs for their drugs, such as through “maximizers” or “accumulators”).
4. Eligible patients must enroll in the Commercial Copay Savings Program, without the help of any insurer, pharmacy benefit manager, or agent to these entities. Pharmacy-assisted enrollment is permitted.
5. Patient agrees, if required by their insurer, to notify the insurer of their participation in the Co-pay Assistance Program.
6. Otsuka reserves the right to rescind, revoke, or amend this offer at any time without notice and for any reason, including to ensure that the offer is used solely for the patient’s benefit.
7. The Commercial Copay Savings Program for JYNARQUE is not insurance and is not intended to substitute for insurance.
8. No purchase necessary, other than of the prescription for JYNARQUE for which assistance is provided under the Copay Savings Program. And
9. The Copay Savings Program is void where taxed, restricted, or prohibited by law or patient’s insurance plan. Beginning May 13, 2025, patients residing in Massachusetts are prohibited from accessing or using the Copay Savings Program, per applicable state laws. Beginning August 13, 2025, patients residing in California are prohibited from accessing or using the Copay Savings Program, per applicable state laws. Notwithstanding the foregoing, patients residing in California may, in accordance with California law, continue to access and use the Copay Savings Program if (i) the applicable patient has completed any applicable step therapy or prior authorization requirements for Jynarque, as mandated by the patient’s health insurer, health care service plan, or other health coverage, or (ii) a generic alternative is not available through the patient’s insurance coverage at a lower cost tier.