Not actual card.
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QULIPTA LIST PRICE
The Wholesale Acquisition Cost (WAC), also known as the list price, for a 30-day supply of QULIPTA is $1092.58 as of January 2024. The WAC may not reflect the price paid by patients.
Because coverage varies by plan, call your insurance company to understand your QULIPTA coverage.
INSURANCE INFORMATION*
Eligible commercially insured patients may pay as little as $0 for their prescription
with the QULIPTA® Complete Savings Card.†
Learn about the QULIPTA Complete Savings Card ›
*Important details about understanding your individual costs:
The chart above provides cost information based on what a person with the type of coverage listed may pay for. Your type of health or prescription insurance plan will determine exactly how much you will pay. Information listed is accurate as of January 2024 and is based on publicly available benefit design information for Medicaid and Medicare Part D out-of-pocket costs for the 2024 plan year.
INSURANCE COVERAGE
SUPPORT
To help you understand your coverage and what your out-of-pocket costs may be, it’s important to verify your benefits.
Because coverage varies by plan, call your insurance company to understand your QULIPTA coverage.
SAVINGS & SUPPORT
MADE SIMPLE
The QULIPTA Complete Savings Card may make prescriptions cost as little as $0† a month for eligible commercially insured patients.
myAbbVie Assist
If you are having difficulty paying for your medicine, myAbbVie Assist may be able to help.
myAbbVie Assist, our patient assistance program, provides AbbVie medicine to qualifying patients. It is intended for people that live in the United States, have limited or no health insurance coverage and demonstrate qualifying financial need.
Visit AbbVie.com/myAbbVieAssist to learn more.
†PROGRAM TERMS AND CONDITIONS:
1. This offer is valid only for patients 18 years of age or older and is good for use only with a valid prescription for QULIPTA® (atogepant) tablets at the time the prescription is filled by the pharmacist and dispensed to the patient. 2. This offer is not valid for use by patients enrolled in Medicare, Medicaid, or other federal or state programs (including any state pharmaceutical assistance programs) or private indemnity or HMO insurance plans that reimburse you for the entire cost of your prescription drugs. If at any time, a participating patient begins receiving prescription drug coverage under any federal, state, or government-funded healthcare program, the patient will no longer be eligible for the Qulipta Complete Savings Card and must cease participation. This offer is not valid for cash-paying patients. 3. Eligible commercially insured patients may pay as little as $0 per monthly prescription fill. Patient out-of-pocket expense will vary; check with your pharmacist for your co-pay discount. Restrictions, including monthly, quarterly, and/or annual maximums, may apply. 4. Subject to all other terms and conditions, a commercially insured patient whose plan covers QULIPTA may receive up to a maximum annual benefit of $7,000 per calendar year, solely for the patient’s benefit, when using the Qulipta Complete Savings Card. Commercially-insured patients for whom coverage is not available because the insurer has not established a coverage review process may be eligible to receive up to 2 one-month fills at no charge for an FDA-approved indication. Under this program, once an insurer has established a review process for coverage requests, commercially insured patients may receive up to a maximum of 2 one-month fills at no charge for an FDA-approved indication while coverage is pending. 5. Patients may not seek reimbursement for value received from the Qulipta Complete Savings Card from any third-party payers. 6. AbbVie reserves the right to rescind, revoke, or amend this offer without notice. 7. Offer good only in the USA, including Puerto Rico, at participating retail pharmacies. Patients residing in or receiving treatment in certain states may not be eligible to participate in this program. 8. Void if prohibited by law, taxed, or restricted. 9. This card is not transferable. The selling, purchasing, trading, or counterfeiting of this card is prohibited by law. 10. This card has no cash value and may not be used in combination with any other discount, coupon, rebate, free trial, or similar offer for the specified prescription. 11. This offer is not health insurance. 12. By redeeming this offer, you acknowledge that you are an eligible commercially-insured patient and that you understand and agree to comply with the above terms and conditions.
For questions about the program, including savings on mail-order prescriptions, or to activate your card ID, please call 1-855-QULIPTA (1.855.785.4782).
To learn about AbbVie’s privacy practices and your privacy choices, visit https://abbv.ie/corpprivacy.
To Pharmacists: For further information, please contact 1-800-364-4767.