This offer is valid toward one of the following products: DYANAVEL® XR (amphetamine) • QUILLIVANT XR® (methylphenidate HCI) • QUILLICHEW ER® (methylphenidate HCI)
TERMS AND CONDITIONS
With the Tris Savings Card, eligible commercially-insured and Cash patients can lower their out-of-pocket costs for DYANAVEL XR, Quillivant XR, and QuilliChew ER. Eligible patients pay the first $25 and the card pays up to the maximum benefit. Commercially-insured includes Covered and Not Covered patients. A patient is considered “New” if they are starting on a Tris product for the first time or they are using a Tris co-pay card for the first time. Patient must present the co-pay card to the pharmacist at the time of fill. A valid Prescriber ID# is required on the prescription. Patients with questions about the Tris Savings Program should call 1-888-840-7006. Restrictions: This offer is valid in the United States and Puerto Rico. Offer not valid for prescriptions reimbursed under Medicaid, a Medicare drug benefit plan, TRICARE, or other federal or state health programs (such as medical assistance programs). Cash Discount Cards and other non-insurance plans are not valid as primary under this offer.
If the patient is eligible for drug benefits under any such program, the patient cannot use this offer. By using this offer, the patient certifies that he or she will comply with any terms of his or her health insurance contract requiring notification to his or her payer of the existence and/or value of this offer. It is illegal to (or offer to) sell, purchase, or trade this offer. This offer is not transferable and is limited to one offer per person. Not valid if reproduced. Void where prohibited by law. Tris Pharma reserves the right to rescind, revoke, or amend this offer without notice at any time. Please see Full Prescribing Information for each product, including Boxed Warning regarding Abuse and Dependence, by choosing the appropriate link at the bottom of this page.