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Androderm full Prescribing Information

Welcome to the Androderm® Savings Program

If you are eligible*, you may pay no more than $30 (with a maximum savings of $50) per prescription fill with an ANDRODERM® Savings Card.

Please see full Prescribing Information, which includes the Patient Information.

*This offer is valid only for patients with ANDRODERM® prescriptions. Depending on insurance coverage, eligible patients pay no more than $30 (with a maximum savings of $50) for each of up to 13 prescription fills. Check with your pharmacist for your copay discount. Maximum savings limit applies; patient out-of-pocket expense may vary. Offer not valid for patients enrolled in Medicare, Medicaid, or other federal or state healthcare programs. Program expires 12/31/17. Please click here for Program Terms, Conditions, and Eligibility Criteria.

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Please tell us about yourself:


By activating your Androderm® Savings Card, you certify that:

  1. You are a resident of the U.S. or Puerto Rico
  2. You have prescription drug insurance
  3. You are over 18 years old
  4. You are not enrolled in a federal- or state-funded prescription drug benefit program, such as Medicare, Medicaid, or any private indemnity or HMO insurance plan that reimburses you for the entire cost of your prescription drugs. You also certify that you are not Medicare-eligible and enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees. You further certify that should you begin receiving prescription benefits from one of these types of programs at any time, you will no longer participate in this savings program
  5. You accept the Program Terms, Conditions, and Eligibility Criteria available here or on back of card

By providing your email address above and by clicking SUBMIT below, you certify that the information provided above is true and correct and that you agree to receive information from Allergan related to Androderm® and the Androderm® [Patient] Savings Program, including site updates, education, and other Allergan products and services. The information pertaining to you that we collect will be used in accordance with our Privacy Statement.

Your use of the Androderm® Savings Card constitutes acceptance of the following Terms and Conditions:

The information pertaining to you that we collect will be used in accordance with our Privacy Policy. Your personal information will not be shared with anyone.

I agree to receive marketing information, offers, refill reminders, and promotions regarding men’s healthcare. I understand that the information that I provide will be used in accordance with the above Privacy Policy. I understand that unless I unsubscribe, my consent will remain valid.

Offer not valid for prescriptions reimbursed in full, or in part, under Medicare, Medicaid, TriCare, or any similar federal or state programs (including pharmaceutical assistance programs), or private indemnity or HMO insurance plans that reimburse you for the entire cost of your prescription drugs. Patients may not use this card if they are Medicare-eligible and enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees. This is not insurance.

By using the offer, you agree that you will not submit a claim for the prescription to a government payor. This offer is only valid in the United States. This offer is void where prohibited by law. The card is not transferable and the amount of the rebate cannot exceed the patient’s out-of-pocket expenses. If any part of your prescription is paid for by a non-governmental third-party payor, you attest to having disclosed this offer to your third-party payor. By using this offer, you are consenting to the collection and use of certain personal information including your phone number and elements of pharmacy claim information. This information will be collected and used by service providers of Allergan, Inc. ("Allergan") in order to administer this program. This information is not provided to Allergan directly. If you do not consent, please do not use this offer. If you require additional assistance, please call 1-855-285-8115.

Allergan reserves the right to rescind, revoke, or amend this offer without notice at any time.