2. Preferred (PA*/ST**)
4. Covered (PA*/ST**)
5. Not covered by formulary
6. All other eligible covered by savings card
*PA = Prior Authorization
**ST = Step Therapy
SOURCE = MMITAnalytics, accessed MMM 2017
The Insulins Valyou Savings Program applies to the cost of medication. There are other relevant costs associated with overall treatment. The products listed are not therapeutically equivalent and are not interchangeable.
*This offer is available to patients paying full retail price with a valid prescription for ADMELOG (insulin lispro injection) 100 Units/mL. This offer is not valid for prescriptions covered by or submitted for reimbursement under Medicare, Medicaid, VA, DOD, or TRICARE, or similar federal or state programs including any state pharmaceutical programs. Void where prohibited by law. Upon registration, patients receive all program details. Sanofi US reserves the right to rescind, revoke, or amend this program without notice.
When using the Savings Card, prices are guaranteed for 12 consecutive monthly fills. For the duration of the program, eligible patients will pay: