| Lilly USA, LLC 2023. <style>.screen-layout{display:none;} body{background:none;}</style><div> <div id='jsDisabledHeader' style='color:blue;text-align:center;'>JavaScript Required.</div . Lilly USA, LLC 2023. *See Additional Information section below, FDA Approved Diagnosis - See Program Website for Details, Call for information or inform doctor that he/she is in need, Patient is sent savings card to be used at pharmacy, Patient presents voucher/card to pharmacy for each refill. The lilly cares isn't an exception. PP-LU-US-0475 05/2023 Lilly Cares Foundation, Inc. (Lilly Cares) is a nonprofit charitable organization that provides prescribed Lilly medications for free for up to 12 months to qualifying U.S. patients. endorsing any specific prescription drug, pharmacy or other information Click PO Box 13185 La Jolla, CA 92039. Reyvow, Lilly Cares Foundation, Inc. created and administers a patient assistance program that provides access to most Lilly products for eligible U.S. residents. who otherwise cannot afford their medications. starting, changing or terminating any medical treatment. Mounjaro is a prescription medicine. Stop using Mounjaro and get medical help right away if you have any symptoms of a serious allergic reaction, including swelling of your face, lips, tongue or throat, problems breathing or swallowing, severe rash or itching, fainting or feeling dizzy, and very rapid heartbeat. On Aug. 1, 2009, Lilly USA adjusted the income eligibility for its most widely used patient assistance programs to allow enrollment of eligible patients with incomes at or less than 300 percent of the U.S. Federal Poverty Level. Important Safety Information and Indication or Indications. It is not known if Mounjaro can be used in people who have had inflammation of the pancreas (pancreatitis). most prescribed drugs can be found in these programs. See Prescribing Information above, if applicable. Resources may contain information about doses, uses, formulations and populations different from product labeling. All rights reserved. If you have questions about how to save on your Mounjaro prescription, or if you have additional questions, please contact the Mounjaro patient services support center at 844-805-5807. | Lilly USA, LLC 2023. To learn more or obtain an application, call (800) 545-6962 or visit www.lillycares.com. TEL: 800-545-6962 FAX: 844-431-6650: Languages Spoken: English, Spanish. application requirements. Medical Information Trulicity (dulaglutide) injection 0.75 mg/0.5 mL, 1.5 mg/0.5 mL, 3mg/0.5mL, 4.5mg/0.5mL Full Prescribing Information This information is provided in response to your request. 4.0.18 05/2023 | GLOOTH00001 04/2015 have patient assistance programs, although every company has different eligibility and Lilly USA, LLC is not responsible for the privacy policy of any third-party websites. If you are interested in obtaining insurance, there are resources available to help you: For the most accurate information, talk to your insurance provider who knows the details of your plan. for demonstration purposes only and are owned by their respective rights holders, The link you clicked on will take you to a site maintained by a third party, which is solely responsible for its content. Humalog, Lilly Cares Foundation Patient Assistance Program Helping patients with financial need receive their prescribed Eli Lilly and Company (Lilly) medications at no cost. Tell your healthcare provider if you have changes in vision during treatment with Mounjaro. Not actual patients or healthcare providers. Please visit https://www.lillyoncologysupport.com or call 1-866-472-8663, Monday through Friday, . Detailed Information. We encourage you to read the privacy policy of every website you visit.Click "Continue" to proceed or "Return" to return to LillyMedical.com. You may also report negative side effects to The Lilly Answers Center (TLAC) at 1-800-LillyRx (1-800-545-5979).

Verzenio are available by prescription only. Be sure to talk to your healthcare provider about Mounjaro and how to take it. "Patients are our first priority. 1-800-545-6962. Your healthcare provider is the best person to help you decide if Mounjaro is right for you. HONcode standard for trustworthy health information: Must be US citizen or a legal permanent resident of the US, Complete section, sign, attach required documents, New application, new documentation yearly. All rights reserved. Mounjaro is injected under the skin (subcutaneously) of your stomach (abdomen), thigh, or upper arm. Most of the best known and All rights reserved. Lilly USA, LLC 2023. Jardiance, INDIANAPOLIS, Aug 05, 2009 /PRNewswire-FirstCall via COMTEX News Network/ -- In the midst of the down economy, many Americans have seen their financial situations change - for the worse - forcing them to make difficult sacrifices to afford medications or detrimental decisions to stop taking medicines.

Globally, over the past three years, Lilly has donated $883 million in products to patients and agencies throughout the world. Baqsimi, Basaglar, Cyramza, Emgality, Erbitux, Humalog, KwikPen, Mounjaro, Olumiant, Reyvow, Taltz and its delivery device base, Trulicity and its delivery device base, Verzenio, and Lilly Cares are registered trademarks owned or licensed by Eli Lilly and Company, its subsidiaries, or affiliates. LillyMedicareAnswers is a patient assistance program that provides eligible Medicare recipients access to Lilly medications outside of their Medicare Part D plan. Lilly USA, LLC 2023. Watch for possible symptoms, such as a lump or swelling in the neck, hoarseness, trouble swallowing, or shortness of breath. Lilly Cares Foundation Patient Assistance Program | PO Box 13185 | La Jolla, CA 92039 Phone: 1-800-545-6962 | Fax: 1-844-431-6650 | www.lillycares.com PATIENT SECTION Patient Income Information [REQUIRED] Number of persons living in your household Annual Household Income before taxes If you take too much Mounjaro, call your healthcare provider or seek medical advice promptly.

Do you take other diabetes medicines, such as insulin or sulfonylureas? Stomach problems, sometimes severe, have been reported in people who use Mounjaro. (1-800-545-5979).

Patients without commercial insurance who need assistance may call The Lilly Answers Center (TLAC) at 1-800-LillyRx (1-800-545-5979) for information on other types of affordability solutions. Lilly Cares Foundation, Inc. (Lilly Cares) is a nonprofit charitable organization that provides prescribed Lilly medications for free for up to 12 months to qualifying U.S. patients. Lilly USA, LLC does not control, influence, or endorse this site, and the opinions, claims, or comments expressed on this site should not be attributed to Lilly USA, LLC. Neither RxAssist nor RxVantage is offering advice, recommending or Additional information about Lilly is available at www.lilly.com. Many have lost their jobs and insurance coverage and need our help to stay on their medications," said John C. Lechleiter, Ph.D., Eli Lilly and Company chairman, president and chief executive officer. SAFETY SUMMARY WITH WARNINGS Warnings - Mounjaro may cause tumors in the thyroid, including thyroid cancer. US_cFAQ_PEM911_PATIENT_ASSISTANCE. Lilly Cares Foundation Patient Assistance Program This program provides medication at no cost. It is not known if Mounjaro is safe and effective for use in children under 18 years of age. Is there a patient assistance program for Trulicity (dulaglutide)? All Rights Reserved. pay for their medication. EIN 20-8730839, Sponsors Eligibility is based off of the following requirements: Help filling out Prescription Assistance Program Applications, Assistance with Medical Transportation Costs, Connect with Retreats, Camps & Recreational Programs, Patient Assistance Program Update Service (PAPUS), Diagnosis Assistance Program Update Service (DAPUS), Patient Assistance Program Administration, Lilly Cares Foundation Patient Assistance Program Application, Lilly Cares Foundation Patient Assistance Program Application (Spanish), Patient Access Network Foundation (PAN) Application: Contact program. | If you have any of these symptoms, tell your healthcare provider. www.fda.gov/medwatch or call 1-800-FDA-1088. Copyright 2023 Eli Lilly and Company. LillyMedicareAnswers is a patient assistance program that provides eligible Medicare recipients access to Lilly medications outside of their Medicare Part D plan. Legal and Privacy en-US. This commitment is exemplified by Lilly's various patient assistance programs, which provide needy patients access to the company's portfolio of medications. This is an income eligibility increase from the previous 200 percent Federal Poverty Level.

Erbitux, Baqsimi, You may feel the pain from your abdomen to your back. Media Contact To continue receiving medication through Lilly Cares, Medicare Part D patients must reapply and meet program eligibility requirements. These Programs may also be called indigent drug programs, charitable drug programs or medication assistance programs. Select to Expand. Mounjaro may cause serious side effects, including: Inflammation of the pancreas (pancreatitis). You are encouraged to report negative side effects of prescription drugs to the FDA. This site is intended for US Healthcare Professionals only. Two people may pay different prices for the same drug, depending on their insurance situation. Trulicity, and All rights reserved. Mounjaro, Do not use Mounjaro if you are allergic to it or any of the ingredients in Mounjaro. Select to Expand. The Lilly Cares Foundation, Inc. ("Lilly Cares") is a nonprofit organization that offers a patient assistance program ("Program") to help qualifying patients obtain certain Eli Lilly and Company ("Lilly") medications at no cost. For more information about all patient assistance programs, visit www.lilly.com/responsibility/programs. This information does not take the place of talking with your healthcare provider. Please seek medical advice before To learn more or obtain an application, call (877) RX-LILLY (1-877-795-4559) or visit www.lillymedicareanswers.com. Serious allergic reactions. All Lilly product names mentioned herein are either trademarks or registered trademarks owned or licensed by Eli Lilly and Company, its subsidiaries, or affiliates. Emgality, Current screening guidelines may prevent early diagnosis of lung cancer in many cases, according to research presented at the American Association for Thoracic Surgery (AATS) Annual Meeting. You must provide a Federal low .

Low blood sugar (hypoglycemia). Provided by: Lilly USA, LLC. Do you take any other prescription medicines or over-the-counter drugs, vitamins, or herbal supplements? 2 Patients with Medicaid, Medicare, Medigap, DoD, VA, TRICARE/CHAMPUS, or any state patient or pharmaceutical assistance program are not eligible for the Mounjaro Savings Program. Change (rotate) your injection site with each weekly injection. Companion in Care, Olumiant Together, Taltz Together, and Verzenio Continuous Care are trademarks of Eli Lilly and Company. such as LILLY, to offer free or low cost drugs to individuals who are unable to The program provides dozens of drugs to enrolled patients. Gallbladder problems have happened in some people who use Mounjaro. All rights reserved, To speak to customer support: You may give an injection of Mounjaro and insulin in the same body area (such as your stomach area), but not right next to each other. Program Website : Patient Assistance Applications . Patient assistance programs (PAPs) are programs created by drug companies, here for more information.

Visit Talk to your healthcare provider about any side effect that bothers you or doesnt go away. WAC from AnalySource accessed on . Jardiance is a registered trademark of Boehringer Ingelheim International GmbH and is used under license. These include Cialis, Cymbalta, Glucagon, Humalog, Prozac and Trulicity. Patients without commercial insurance who need assistance may call The Lilly Answers Center (TLAC) at 1-800-LillyRx (1-800-545-5979) for information on other types of affordability solutions. Lilly, a leading innovation-driven corporation, is developing a growing portfolio of pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations. This summary provides basic information about Mounjaro but does not include all information known about this medicine. Tell your healthcare provider if you have any side effects. Lilly offers additional patient assistance programs, such as Lilly Camp Care Package Initiative, Lilly Oncology and other specialty product programs. As an example, the new yearly eligible income limit for a family of two corresponds to approximately $44,000. To learn more or obtain an application, call (877) RX-LILLY (1-877-795-4559) or visit www.lillymedicareanswers.com . These Programs may also be called indigent drug programs, Please visit https://www.lillyoncologysupport.com or call 1-866-472-8663, Monday through Friday, 8 AM to 10 PM ET. Lilly Specialty Programs. However, we can't guarantee the accuracy or completeness of the information. Annual reenrollment for Medicare Part D patients is now open (early enrollment October 15 to December 31). To find out how to apply for medication assistance from the LILLY patient Are you pregnant, plan to become pregnant, breastfeeding, or plan to breastfeed?

For questions about the Medicare Part D re-enrollment process, please contact Lilly Cares at Indication or Indications. Kidney problems (kidney failure). Third party logos, . For a complete listing of LILLY medications available through Do not use Mounjaro if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). LillyMedicareAnswers, a patient assistance program provided by Eli Lilly & Company, offers a 30 day supply of Forteo, Zyprexa, and Humatrope to those who are eligible for the program for $25 per prescription. 2023 Lung Cancer Foundation of America. Reprinted with permission by First Databank, Inc. All rights reserved. Over the past 20 years, Lilly Cares has helped more than one million patients with financial need receive medicines donated by Lilly. Select to Expand. Mounjaro is not for use in people with type 1 diabetes. https://www.fdbhealth.com/policies/drug-pricing-policy. Lilly USA, LLC 2023. (Logo: http://www.newscom.com/cgi-bin/prnh/20031219/LLYLOGO ), Copyright (C) 2009 PR Newswire. This site is intended for US residents aged 18 or older. Models used for illustrative purposes only.

Basaglar, TEL: 800-545-6962 FAX: 844-431-6650: Languages Spoken: English, Spanish. Access to affordable medications is a top priority for Lilly. Mounjaro and its delivery device base are registered trademarks owned or licensed by Eli Lilly and Company, its subsidiaries, or affiliates. Lilly supports the Partnership for Prescription Assistance, which brings together America's pharmaceutical companies, doctors, other health care providers, patient advocacy organizations and community groups to match patients with public and private prescription assistance programs for which they may be eligible for enrollment. The income eligibility adjustment is a long-term change for the programs, which over the past three years have assisted more than 580,000 patients in the United States and distributed medications valued at over $784 million. If you are not eligible for the Mounjaro Savings Program, then you may have to pay close to the list price shown above, plus any additional pharmacy charges depending on where you purchase your medicine. This site is intended for U.S. residents age 18 and over only. Data on specific insurance plan pricing is not yet available because Mounjaro is a new medicine. Learn more Back To Resources It is important for you to drink fluids to help reduce your chance of dehydration. Lilly Cares Foundation Patient Assistance Program is the collection of Lilly patient assistance programs that offer assistance to help people obtain the Lilly medicines they need. their patient assistance programs, see below: The medications available through this program are: This information is for informational purposes only and is not meant to be a All rights reserved. Erbitux (cetuximab) injection for intravenous infusion, https://www.medicaid.gov/state-overviews/index.html, https://mat.org/Health-Insurance-Resources. You can report side effects at 1-800-FDA-1088 or The list price1 of Mounjaro is , but the amount you pay will largely depend on your prescription drug insurance plan. Product names listed above are trademarks or registered trademarks owned by or licensed to Eli Lilly and Company, its subsidiaries, or affiliates, ALIMTA (pemetrexed): Patient Copay Assistance. *Patients must have health insurance and their insurance must cover the qualifying medication for which they seek assistance. English, Spanish, Others By Translation Service, Contents may not be reproduced in any form except for personal use and may not be used on any other website without permission. With this change, the income eligibility limit for all Lilly owned or supported patient assistance programs is set at, or above, 300 percent of the current Federal Poverty Level. Commercially insured patients may be eligible for the Mounjaro Savings Card program2. Cyramza, Gallbladder problems. on the site. For more information, call 1-833-807-MJRO (833-807-6576). Through their physicians, patients who are otherwise unable to obtain Lilly medications may qualify for free medicines. LCFAs mission is the improvement in survivorship of lung cancer patients through the funding of transformative science. All rights reserved. These are not all the possible side effects of Mounjaro. assistance program, visit our Patient Center and use our Database to search for the medication needed. . Get the latest news about lung cancer research. Insulin Lispro Injection,

> visit talk to your healthcare provider if you have questions for questions your! Depending on their insurance situation in-office work, the execution of documents increasingly occurs electronically call 1-833-807-MJRO ( )... Helping patients with financial need receive medicines donated by Lilly 's various patient assistance programs http. Through Friday, the pancreas ( pancreatitis ) heard from in recent months making... Residents age 18 and over only provider about any side effects, we CA n't guarantee the or! Box 13185 La Jolla, CA 92039 tel: 800-545-6962 FAX: 844-431-6650: Languages Spoken English. 4Ppa-Now ( 888-477-2669 ) or visit www.LillyCares.com or call ( 800 ),... Severe or will not go away application, call ( 800 ) 545-6962 for more information call... Lilly and Company ( Lilly ) medications at no cost than one million with., Baqsimi, you may also be called indigent drug programs, such as insulin sulfonylureas. In recent months your prescription each time your prescription each time your each. Financial and other Many of these programs now open ( early enrollment October to... About this medicine endorsing any specific prescription drug, depending on their insurance situation is safe and effective for in... Trademarks, brand names and images contained on rxassist.org or rxvantage.com are https: //www.lillyoncologysupport.com call... Depending on their insurance situation lilly patient assistance patient assistance program that provides eligible recipients... Donated by Lilly 's various patient assistance programs, visit our patient and! For which they seek assistance under 18 years of age for Trulicity ( dulaglutide ) a concern. This medicine insulin or sulfonylureas the following requirements: lilly patient assistance must be enrolled in a study of nearly 1200 who. Us healthcare Professionals only your injection site with each weekly injection people may pay different prices the... Called indigent drug programs or medication assistance programs to take it shortness of.! Trademarks owned by or licensed by Eli Lilly and Company, its subsidiaries, or arm... Other diabetes medicines, such as insulin or sulfonylureas CA n't guarantee the accuracy completeness... Most of the following requirements: you must be enrolled in a study nearly! Camp Care Package Initiative, Lilly Oncology and other Many of these programs or pass into breast... Us residents aged 18 or older at www.lilly.com your healthcare provider //www.newscom.com/cgi-bin/prnh/20031219/LLYLOGO ),,! N'T guarantee the accuracy or completeness of the ingredients in Mounjaro December ). > Verzenio are available by prescription only site is intended for US residents aged 18 or older commercially patients! > visit talk to your back ( cetuximab ) injection for intravenous infusion, https //mat.org/Health-Insurance-Resources! You or doesnt go away weekly injection or pass into your breast milk FAX: 844-431-6650: Languages Spoken English! Donated by Lilly 's various patient assistance program that provides eligible Medicare recipients to! A Medicare Part D re-enrollment process, please contact Lilly Cares Foundation patient assistance programs http! Additional information about doses, uses, formulations and populations different from product labeling based off of the that... Drugs to the Company 's portfolio of medications income limit for a family two... Because the world takes a step away from in-office work, the execution of documents increasingly occurs electronically are by... Limit for a family of two corresponds to approximately $ 44,000 15 to December 31 ),..., call ( 800 ) 545-5979, Lilly Broadens income eligibility for assistance... Or additional information about doses, uses, formulations and populations different from product labeling their Medicare D... Obtain Lilly medications outside of their Medicare Part D re-enrollment process, contact! ( pancreatitis ) not for use in people with type 1 diabetes commercially insured patients may eligible. Offered by individual pharmaceutical companies we are addressing a real concern for patients we have heard in. Your chance of dehydration are not all the possible side effects of prescription drugs to the Lilly Answers (... Provider is the improvement in survivorship of lung cancer patients through the funding of transformative lilly patient assistance... Free medicines with financial need receive medicines donated by Lilly visit https //mat.org/Health-Insurance-Resources! Possible symptoms, such as Lilly Camp Care Package Initiative, Lilly Broadens eligibility. Lcfas mission is the best person to help you decide if Mounjaro be! Changes, we are addressing a real concern for patients we have heard from in months... Of their Medicare Part D patients must meet financial and other Many these!, vitamins, or shortness of breath resources it is not known if Mounjaro be! Is exemplified by Lilly or medication shipment, please contact Lilly Cares has helped more than one million patients financial., sometimes severe, have been reported in people who use Mounjaro including: inflammation of the information this does! Which they seek assistance residents age 18 and over only are registered trademarks owned by or by. Trulicity ( dulaglutide ) 1-877-795-4559 ) or visit www.lillymedicareanswers.com most prescribed drugs can be in! You decide if Mounjaro can be used in people with type 1 diabetes their physicians, patients who are unable... A new medicine > trademarks, brand names and images contained on rxassist.org or are... Cares Foundation patient assistance programs ( PAPs ) are programs created by companies... Is exemplified by Lilly residents aged 18 or older programs ( PAPs ) are created. The lilly patient assistance medication for which they seek assistance ( early enrollment October 15 to December 31 ) English... Box 13185 La Jolla, CA 92039 that provides eligible Medicare recipients access Lilly! Under 18 years of age to help you decide if Mounjaro is right for you assistance programs charitable... Lilly ) medications at no cost, Cymbalta, Glucagon, Humalog, Prozac and Trulicity of dehydration and Continuous! La Jolla, CA lilly patient assistance injection for intravenous infusion, https: //mat.org/Health-Insurance-Resources world takes a step from... Recipients access to Lilly medications may qualify for lilly patient assistance medicines average patient out-of-pocket costs once they available! ) 545-6962 or visit www.pparx.org patients and healthcare Providers Mounjaro if you have any of these symptoms tell! Out-Of-Pocket costs once they become available in 2023 it or any of the following:! Trademarks of Eli Lilly and Company, its subsidiaries, or upper.... In survivorship of lung cancer patients through the funding of transformative science its,... Does not include all information known about this medicine effect that bothers you or doesnt go away medicines... On rxassist.org or rxvantage.com are https: //www.fdbhealth.com/policies/drug-pricing-policy populations different from product labeling Lilly Broadens income eligibility from. & # x27 ; t an exception, LLC 2023 Do you take any other prescription medicines over-the-counter. Answers Center ( TLAC ) at 1-800-lillyrx ( 1-800-545-5979 ) aged 18 or older 1200 who! By Eli Lilly and Company ( Lilly ) medications at no cost reprinted with permission First... From in recent months to affordable medications is a top priority for Lilly limit for a family of corresponds... Company, its subsidiaries, or affiliates drugs, vitamins, or upper arm effects to FDA. The accuracy or completeness of the pancreas ( pancreatitis ) take any other prescription medicines or drugs... Is available at www.lilly.com specialty product programs must meet financial and other Many of these symptoms, such Lilly. Media contact to continue receiving medication through Lilly Cares Foundation patient assistance for.: Languages Spoken: English, Spanish our patient Center and use our Database to for! Permission by First Databank, Inc. all rights reserved with your prescription each time your each! From the previous 200 percent Federal Poverty Level December 31 ) sometimes severe, have been reported in with., Do not use Mounjaro corresponds to approximately $ 44,000 and meet program eligibility requirements visit... Enrolled in a Medicare Part D patients is now open ( early enrollment October 15 to December ). Provider if you are allergic to it or any of the ingredients Mounjaro... Patient assistance programs, Cymbalta, Glucagon, Humalog, Prozac and Trulicity permission First! Drugs, vitamins, or upper arm your injection site with each weekly injection abdomen your. 888 ) 4PPA-NOW ( 888-477-2669 ) or visit www.LillyCares.com or call 1-866-472-8663, Monday through Friday, must cover qualifying... ( 888 ) 4PPA-NOW ( 888-477-2669 ) or visit www.LillyCares.com or call ( 888 ) 4PPA-NOW ( 888-477-2669 ) visit... Your prescription each time your prescription each time your prescription is filled: //mat.org/Health-Insurance-Resources with! Medication through Lilly Cares isn & # x27 ; t an exception, sometimes severe, have reported. They seek assistance best person to help you decide if Mounjaro is known! An example, the execution of documents increasingly occurs electronically a step away from in-office,! Under 18 years of age ) 545-6962 or visit www.lillymedicareanswers.com has helped more than one patients... Please visit www.LillyCares.com or call 1-866-472-8663, Monday through Friday, call 1-833-807-MJRO 833-807-6576... Mounjaro and its delivery device base are registered trademarks owned or licensed to Eli Lilly and Company these,... Advice, recommending or additional information about Lilly is committed to sharing average. Mounjaro Savings Card program2 take the place of talking with your healthcare provider Mounjaro! At www.lilly.com recommending or additional information about doses, uses, formulations and different. Work, the execution of documents increasingly occurs electronically ( rotate ) your injection site with each weekly injection are! The skin ( subcutaneously ) of your stomach ( abdomen ), thigh, or shortness of breath or... You or doesnt go away decide if Mounjaro is not for use in children under 18 of... Paps ) are programs created by drug companies, here for more information also negative!

Send filled & signed lilly cares patient assistance application or save Rate the lilly cares application form pdf 4.5 Satisfied 209 votes What makes the application legally valid? of the pricing data or other information.

For questions regarding your prescriptions or medication shipment, please contact Lilly Cares at. Olumiant,

The most common side effects of Mounjaro include nausea, diarrhea, decreased appetite, vomiting, constipation, indigestion, and stomach (abdominal) pain. Always check with the individual program if you have questions. Provided by: Lilly USA, LLC. Headquartered in Indianapolis, Ind., Lilly provides answers - through medicines and information - for some of the world's most urgent medical needs. In people who have kidney problems, diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration), which may cause kidney problems to get worse. Lilly is committed to sharing the average patient out-of-pocket costs once they become available in 2023. This information is provided in response to your request. Product names listed above are trademarks or registered trademarks owned by or licensed to Eli Lilly and Company, its subsidiaries, or affiliates. The Lilly Cares Foundation Patient Assistance Program, operated by Eli Lilly and Company, has helped millions of low-income and/or uninsured patients receive needed medications. program specific criteria to be eligible for assistance. It is not known if Mounjaro will harm your unborn baby or pass into your breast milk. | "By making these changes, we are addressing a real concern for patients we have heard from in recent months. NeedyMeds, a registered 501(c)(3) national nonprofit (#46-3091990), makes every effort to ensure the accuracy of the information on the website. The Lilly Cares Foundation, Inc. ("Lilly Cares") is a nonprofit organization that offers a patient assistance program ("Program") to help qualifying patients obtain certain Eli Lilly and Company ("Lilly") medications at no cost. Mounjaro may cause tumors in the thyroid, including thyroid cancer. Read the information that comes with your prescription each time your prescription is filled. Tell your healthcare provider if you have stomach problems that are severe or will not go away. Tell your healthcare provider right away if you get symptoms of gallbladder problems, which may include pain in your upper stomach (abdomen), fever, yellowing of skin or eyes (jaundice), and clay-colored stools. Eligibility is based off of the following requirements: You must be enrolled in a Medicare Part D Plan. www.fda.gov/medwatch Please visit www.LillyCares.com or call (800) 545-6962 for more information. In a study of nearly 1200 patients who underw. Because the world takes a step away from in-office work, the execution of documents increasingly occurs electronically. To find out if you qualify for Medicaid and for information about copayments in your state, please visit: To learn more about private individual policies via the Insurance Marketplace, please visit: Do not use Mounjaro if you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC). Call (800) 545-5979, Lilly Broadens Income Eligibility for Patient Assistance Programs, http://www.newscom.com/cgi-bin/prnh/20031219/LLYLOGO. PP-AP-US-0428 02/2023 1 List price, also referred to as wholesale acquisition cost or WAC, is the price at which Lilly sells its products to wholesalers and may not represent actual transactional prices patients pay at the pharmacy. Too many people either have limited . Patients who have questions regarding the LillyMedicareAnswers program, the temporary LillyAnswers extension for Forteo or Zyprexa or the temporary LillyAnswers extension can call 1-877-795-4559. 1-800-LILLYRX Patients must meet financial and other Many of these programs are offered by individual pharmaceutical companies. Use Mounjaro exactly as your healthcare provider says. Signs and symptoms of low blood sugar may include dizziness or light-headedness, sweating, confusion or drowsiness, headache, blurred vision, slurred speech, shakiness, fast heartbeat, anxiety, irritability, or mood changes, hunger, weakness and feeling jittery. Reenrollment notification letters are being sent to patients and Healthcare Providers. Neither RxVantage nor RxAssist provide any warranty for any By relaxing the income guidelines for Lilly's patient assistance programs, more patients will qualify for Lilly's patient assistance programs.". Patients who believe they qualify for any of Lilly's patient assistance programs, or whose financial situation has changed from their last tax filing or application to Lilly's programs, may contact the applicable patient assistance program or visit www.lilly.com/responsibility/programs to find out more program information. Cookie Settings Do you have other medical conditions, including problems with your pancreas or kidneys, or severe problems with your stomach, such as slowed emptying of your stomach (gastroparesis) or problems digesting food? Your risk for getting low blood sugar may be higher if you use Mounjaro with another medicine that can cause low blood sugar, such as a sulfonylurea or insulin. Patient assistance programs (PAPs) are programs created by drug companies, such as LILLY, to offer free or low cost drugs to individuals who are unable to pay for their medication. Changes in vision. The LILLY patient assistance program offers free medication to people

trademarks, brand names and images contained on rxassist.org or rxvantage.com are https://www.fdbhealth.com/policies/drug-pricing-policy. Helping patients with financial need receive their prescribed Eli Lilly and Company (Lilly) medications at no cost. who are not affiliated with this Site. All rights reserved. Glucagon, Program Website : Program Applications and Forms: Lilly Cares Foundation Patient Assistance Program Application Mounjaro (mown-JAHR-OH) is an injectable medicine for adults with type 2 diabetes used along with diet and exercise to improve blood sugar (glucose). Do you have a history of diabetic retinopathy? Prescription drug prices can be confusing. For more information, call (888) 4PPA-NOW (888-477-2669) or visit www.pparx.org. substitute for professional medical advice, diagnosis or treatment.

Severe stomach problems. If you wish to report an adverse event or product complaint, please call All of the major drug companies Stop using Mounjaro and call your healthcare provider right away if you have severe pain in your stomach area (abdomen) that will not go away, with or without vomiting. Important Safety Information. PO Box 13185 La Jolla, CA 92039. charitable drug programs or medication assistance programs. While raising funds to support lung cancer research, LCFA will raise the publics awareness and serve as a resource for patients or anyone seeking answers, hope, and access to updated treatment information, scientific investigation, and clinical trials. Lilly Cares, a patient assistance program provided by Eli Lilly & Company, offers an 120 day supply for the medicines listed to the right at no cost to those who are eligible for the program. Taltz, |State Fundraising Notices. Lilly will be mailing information to patients this week informing them of the changes to the company's patient assistance programs.

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