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Click Here for Indications VIVITROL is indicated for:
  • The treatment of alcohol dependence in patients who are able to abstain from alcohol in an outpatient setting prior to initiation of treatment with VIVITROL. Patients should not be actively drinking at the time of initial VIVITROL administration.
  • The prevention of relapse to opioid dependence, following opioid detoxification.

VIVITROL should be part of a comprehensive management program that includes psychosocial support.

The VIVITROL® Co-pay Savings Program covers up to $500/month of co-pay or deductible expenses for eligible patients with a VIVITROL prescription. Terms and Conditions apply.*

Get your patient’s card today in just 3 steps:

1

Confirm your patient’s eligibility

Is your patient 18 years or older?

What type of insurance will your patient use to pay for their VIVITROL prescription (select all that apply)?

Note: Patients using federal or state healthcare programs to purchase their VIVITROL prescription are not eligible.

Commercial health insurance purchased through your employer or purchased personally, and which does not include the other insurance types listed below

No insurance/cash paying

Medicare, including Medicare Part D or Medicare Advantage plans

Medicaid, including Medicaid Managed Care and Alternative Benefit Plans (“ABPs”) under the Affordable Care Act

Medigap

Veterans Administration (“VA”)

Department of Defense (“DoD”)

TRICARE

State-funded programs such as medical or pharmaceutical assistance programs and residential correctional programs

Check eligibility
Sorry, your patient is not eligible. You can:
  • View eligibility requirements below
  • Review fields and start over
  • If you believe you have received this message in error, please call 1-800-VIVITROL (1-800-848-4876), Monday–Friday, 9:00 AM–8:00 PM (ET)

2

Sign up for the program

Your patient’s contact information

Privacy is very important to us. Please see our privacy policy. All fields are required unless marked optional.

By submitting this form, you are confirming that:

  • Your patient is 18 years or older
  • Your patient is not using any federal or state healthcare programs to pay for their VIVITROL prescription
  • Your patient is being treated for alcohol dependence or opioid dependence

We're sorry, something went wrong. Please try again later or call 1-800-VIVITROL (1-800-848-4876) for assistance.

Get co-pay card

3

Get your patient’s co-pay card

Your patient’s Co-pay Savings Program card

A pharmacy may call you to confirm your patient’s prescription. Please ask your patient to provide the RxID number on their Co-pay Savings Program card when asked for their card number.
VIVITROL® Co-pay Savings Program card
VIVITROL® Co-pay Savings Program card
Get co-pay card
VIVITROL Co-pay Savings Program card
Who is eligible for the Co-pay Savings Program?

To be eligible for the Co-pay Savings Program, patients must:

  • Be 18 years or older
  • Have a prescription for VIVITROL for an FDA-approved indication
  • Have commercial health insurance or pay with cash
91%
of eligible patients using the VIVITROL® Co-pay Savings Program had no out-of-pocket costs for VIVITROL. (for period January 2020 - December 2020).1
Who is not eligible for the Co-pay Savings Program?

Patients using federal or state healthcare programs to purchase their VIVITROL prescription, including:

  • Medicare, including Medicare Part D or Medicare Advantage plans
  • Medicaid, including Medicaid Managed Care or Alternative Benefit Plans under the Affordable Care Act
  • Medigap
  • Veterans Administration
  • Department of Defense
  • TRICARE
  • State-funded programs such as medical or pharmaceutical assistance programs and residential correctional programs

*Terms and Conditions

Eligibility for Alkermes-Sponsored Co-pay Savings. This offer is only available to patients 18 years or older, with a prescription consistent with the Prescribing Information and the patient is not enrolled in, or covered by, any local, state, federal or other government program that pays for any portion of medication costs, including but not limited to Medicare, including Medicare Part D or Medicare Advantage plans; Medicaid, including Medicaid Managed Care and Alternative Benefit Plans under the Affordable Care Act; Medigap; VA; DOD; TRICARE; or a residential correctional program.

Additional Terms of Use: This offer is not conditioned on any past, present, or future purchase, including refills. Alkermes reserves the right to rescind, revoke, or amend this offer, program eligibility, and requirements at any time without notice. This offer is limited to one per patient, may not be used with any other offer, is not transferable and may not be sold, purchased or traded, or offered for sale, purchase or trade. Void where prohibited by law. Program Administrator or its designee will have the right upon reasonable prior written notice, during normal business hours, and subject to applicable law, to audit compliance with this program.

See Important Safety Information. Discuss all benefits and risks with your patients.

See Prescribing Information. Review Medication Guide with your patients.

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Reference: 1. Based on claims data derived from commercially insured patients enrolled in the VIVITROL® Co-pay Savings Program from January 2020 through December 2020. Data are not state specific.

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Reference: 1. Based on claims data derived from commercially insured patients enrolled in the VIVITROL® Co-pay Savings Program from January 2020 through December 2020. Data are not state specific.

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