With the ACIPHEX® Copay Savings Card you may pay as little as $5.00 for your prescription*.
*Copay Savings Card only works on brand-name ACIPHEX®. Terms and conditions apply.
Waylis Therapeutics is a patient-first company, and we are continuously developing access and affordability programs to make sure that ACIPHEX® is easily accessible for those who need it.
ACIPHEX® Savings Program Information:
Show the information below to your pharmacist along with your valid commercial insurance information.
BIN #: 610600
PCN#: AS
RxGroup: 374
ID#: 37401140253
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Terms and Conditions
Offer valid for commercially insured patients who have a valid ACIPHEX® prescription. No substitutions permitted.
Not valid to individuals with Medicare Medicaid, TRICARE or any similar state or federal healthcare programs.
Benefit limited to one use per person for any 30-day period.
Valid only at participating pharmacies.
This offer is non-transferable, no substitutions are permissible, and offer may not be combined with any other coupon, discount, prescription savings card, free trial, or similar offer for specified prescription.
Federal law prohibits the selling, purchasing, trading, or counterfeiting of this Savings Card.
Offer only valid in the United States, Puerto Rico, or other selected U.S. Territories; this offer void in California, Massachusetts or where restricted or prohibited by law.
The value of the Program is intended exclusively for the benefit of the patient. The Program is not intended for the benefit of third parties, including without limitation third party payers, pharmacy benefit managers, or their agents. Waylis will monitor program utilization data and reserves the right to discontinue or place monthly limits on co-pay assistance at any time if Waylis determines that the individual is subject to a plan that benefits third parties.
This offer is not conditioned on any past, present, or future purchase, including refills.
Waylis Therapeutics reserves the right to rescind, revoke or amend the program without notice.
Offer not applicable to co-pays of $5.00 or less.
Eligible patients may pay as little as $5.00 for their prescription. By using this Savings Offer, eligible patients may receive a savings of up to $55.00 per fill off their co-pay or out-of-pocket costs.