Now, Most Patients with Commercial Insurance will Pay Only $10 for Each GLUMETZA® Prescription.*
Two ways to save!
Option 1:
eVoucher Rx™ Program—No cards or coupons needed!
- Take your GLUMETZA prescription to one of the more than 33,000 participating pharmacies nationwide (see chart below for a list of participating pharmacies).
- Get an automatic co-pay reduction at the pharmacy counter when you pick up your GLUMETZA prescription. No card or coupon needed!
| Participating Pharmacies† | ||
|---|---|---|
| Ahold | Fred's | Publix Pharmacy |
| Albertsons Pharmacy | Fry's | Q Pharmacy |
| Bakers Pharmacy | Genuardis Pharmacy | QFC |
| Bashas | Gerbes Pharmacy | Quality Pharmacy |
| Bi Lo Pharmacy | Giant Eagle | Rainbow Pharmacy |
| Big Y Pharmacy | Giant Pharmacy | Ralphs |
| Bi-Lo Foods | Haggen | Randalls |
| Bioscrip Pharmacy | Harris Teeter | Rite Aid Pharmacy |
| Brookshire Brothers Pharmacy | Health Mart Pharmacy | Safeway Pharmacy |
| Buehler's | H-E-B | Sams Pharmacy |
| Carrs | Horton and Converse Pharmacy | Sav-On Pharmacy |
| City Markets | Ingles Pharmacy | Schnucks |
| Copps Food Center Pharmacy | Jay C Food Stores | Scotts Pharmacy |
| Costco Pharmacy | Kerr Drug | Shaws Osco Pharmacy |
| Cub Pharmacy | King Soopers | Shop N Save Pharmacy |
| CVS Pharmacy | Kinney Drugs | Shoppers Pharmacy |
| CVS Procare | Kroger Pharmacy | Smith's |
| Dierbergs | Lewis Drug | Southern Family Market |
| Dillon Pharmacy | Longs Drug | Stop & Shop Pharmacy |
| Doc's Drugs | Marc's | Super D Drugs |
| Dominick's | Martin's Pharmacy | Target Pharmacy |
| Drug Emporium | Mays | Tom Thumb |
| Drug Mart | Meijer | Tops Pharmacy |
| Drug Warehouse | Minyard Food & Drug | USA Drug |
| Duane Reade | Neighborcare | Vons |
| Econofoods Pharmacy | Osco Pharmacy | Walgreens |
| Farm Fresh Pharmacy | P&C Pharmacy | Wal-Mart Pharmacy |
| Food 4 Less Pharmacy | Pamida Pharmacy | Wegmans |
| Food City | Pick N Save Pharmacy | |
| Fred Meyer Pharmacy | Price Chopper | |
| Plus more than 6,300 independent pharmacies | ||
†Participation status subject to change. For a current list of participating pharmacies, please visit: http://evoucherrx.relayhealth.com/storelookup.
Option 2:
GLUMETZA Instant Savings Card
- If you use a pharmacy that does not participate in the eVoucher Rx™ Program, ask your doctor for a GLUMETZA Instant Savings Card or download it now.
- Take the card to your pharmacy along with your GLUMETZA prescription.
- Show the card to the pharmacist at the same time you present your GLUMETZA prescription. Keep your card in a safe place. If you change pharmacies, you will need to show your card again.
Program details—How it works
eVoucherRx™ Program and GLUMETZA® Instant Savings Card
By participating in this savings program, participants understand and agree that the information provided, as well as information obtained about them from the pharmacy, will be shared with the manufacturer and by 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.
Terms and Conditions
- Offer applies to out-of-pocket expenses (co-pay) greater than $10. Out-of-pocket expenses greater than $10 will be covered up to $100 per prescription. If your total out-of-pocket cost exceeds $100, you will be responsible for a $10 co-pay plus any additional amount over $100. If your co-pay is already $10 or less, this offer does not apply.
- 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.
- This offer is void where taxed, restricted, or prohibited by law.
- This offer is limited to one card per patient.
- Santarus, Inc. reserves the right to modify or cancel this program at any time.
- eVoucherRx™ is not extended on prescriptions for patients:
- Who are cash-paying customers
- Using mail-order or institution-based pharmacies to fill their prescriptions, or who are federal or state government employees
- Who are filling their prescriptions at nonparticipating pharmacies
- The GLUMETZA Savings Card may be used for cash-paying patients
- Participating patients must re-present their GLUMETZA Instant Savings Card if changing pharmacies
- This savings card is not transferable and cannot be used in conjunction with eVoucherRx™
Mail Order
- The GLUMETZA Instant Savings Card may be used for mail-order prescriptions
- Reimbursement:
- Benefits that were unable to be processed through mail order may qualify for reimbursement. Please visit https://www.patientrebateonline.com for instructions on how to mail in your prescription receipt for reimbursement
- eVoucherRx™ is not extended on prescriptions for patients using mail order
Learn more about GLUMETZA®, a first-line treatment for type 2 diabetes that may help minimize stomach-related side effects, such as nausea, in the first week of taking the medication.
*Restrictions apply. Please see "Terms and Conditions" above.
