VASCEPA (icosapent ethyl) MOBILE PROGRAM TERMS
- By opting into the VASCEPA (icosapent ethyl) Mobile Program ("Program"), in which you can receive your Copay Savings Card via text, you consent to receive approximately 5 text messages and/or push notifications per month from Amarin. Such messages may be marketing or non-marketing messages and may include, for example, refill reminders, fill confirmation, website information, etc. T-Mobile is NOT liable for delayed or undelivered messages.
- To stop receiving text messages, text STOP to 26789. DOING SO WILL ONLY OPT YOU OUT OF THE VASCEPA (icosapent ethyl) MOBILE PROGRAM; you will remain opted into any other Amarin text message program(s) to which you separately opted in. You may unsubscribe from the digital wallet message Program at any time by disabling push notifications or removing the digital wallet pass from your device for digital wallet programs.
- To request more information or to obtain help, text HELP to 26789. You can also call customer service at 1-800-422-5604.
- You represent that you are the account holder for the mobile telephone number(s) that you provide to opt in to the texting program. You are responsible for notifying Amarin immediately if you change your mobile telephone number. You may notify Amarin of a number change by re-enrolling in the program.
- Message and data rates may apply to each text message sent or received in connection with the texting program, as provided in your mobile telephone service rate plan, in addition to any applicable roaming charges. Charges are both billed and payable to your mobile service provider or deducted from your prepaid account. Amarin does not impose a separate fee for sending text messages.
- Data obtained from you in connection with this Short Message Service (SMS) texting program may include your telephone number; your carrier's name; and the date, time, and content of your messages. Amarin may use this information to contact you and to provide the services you request from us.
- Amarin will not be liable for any delays in the receipt of any SMS messages, as delivery is subject to effective transmission from your network operator.
- The service is available only on these US participating mobile carriers: Verizon Wireless, Sprint, Nextel, Boost Mobile, T-Mobile, AT&T, Alltel, ACS Wireless, Bluegrass Cellular, Carolina West Wireless, Cellcom, Cellular One of East Central Illinois (ECIT), Cincinnati Bell, Cricket Wireless, C Spire Wireless, Duet IP (AKA Max/Benton/Albany), Element Mobile, Epic Touch, GCI Communication, Golden State Cellular, Hawkeye (Chat Mobility), Hawkeye (NW Missouri Cellular), Illinois Valley Cellular (IVC), Inland Cellular, iWireless, Keystone Wireless (Immix/PC Management), MetroPCS, Mobi PCS, Mosaic Telecom, MTPCS/Cellular One (Cellone Nation), Nex-Tech Wireless, nTelos, Panhandle Telecommunications, Pioneer, Plateau, Revol Wireless, Rina-Custer, Rina-All West, Rina-Cambridge Telecom Coop, Rina-Eagle Valley Comm, Rina-Farmers Mutual Telephone Co, Rina-Nucla Nutria Telephone Co, Rina-Silver Star, Rina-South Central Comm, Rina-Syringa, Rina-UBET, Rina-Manti, Simmetry Wireless, South Canaan (Cellular One of NEPA), Thumb Cellular, Union Wireless, United Wireless, U.S. Cellular, Viaero Wireless, Virgin Mobile, West Central Wireless (includes Five Star Wireless).
- You agree to indemnify Amarin and parties texting on its behalf in full for all claims, expenses, and damages related to or caused in whole or in part by your failure to notify us if you change your telephone number, including but not limited to all claims, expenses, and damages related to or arising under the Telephone Consumer Protection Act.
- Amarin may suspend or terminate your receipt of text messages if it believes you are in breach of these SMS Terms and Conditions. Your receipt of text messages is also subject to termination in the event that your mobile telephone service terminates or lapses. Amarin reserves the right to modify or discontinue, temporarily or permanently, all or any part of the text messaging services you receive, with or without notice.
- Amarin may revise, modify, or amend these SMS Terms and Conditions at any time. Any such revision, modification, or amendment shall take effect when it is posted to Amarin's website. You agree to review these SMS Terms and Conditions periodically to ensure that you are aware of any changes. Your continued consent to receive text messages will indicate your acceptance of those changes.
TERMS AND CONDITIONS
The patient is responsible for the first $9 of their copay and the card pays up to the next $150 of their remaining copay due per monthly fill of $450 on a 90 day fill prior to 12/31/2021. Prescriber ID# required on prescription. Not for use by residents of VT, nor Medical professionals licensed in VT. May not be used to obtain prescription drugs paid for by Federal or State Healthcare Programs including Medicare Part D. This offer is not valid for those patients under 18 years of age or patients whose plans do not permit use of a copay card.
Offer restrictions: May not be used to obtain prescription drugs paid for in part by Federal or State Healthcare Programs including Medicare, Medicaid, Medicare Advantage, Medicare Part D, Tricare, and VA. Not for use by VT residents, VT licensed medical professionals, patients under 18, where prohibited by law or patient's insurance plan, or where taxed or restricted. Maximum savings of $150 per month or $450 per 90 day supply. Eligible patients include those who participate in commercial insurance, through a healthcare exchange, or pay cash. Offer good through December 31, 2021.
Patient Instructions: In order to redeem this card you must have a valid prescription for VASCEPA (icosapent ethyl) and otherwise meet all eligibility criteria. Follow the dosage instructions given by the doctor. This card may not be redeemed for cash. Cardholders with questions, please call 1-855-497-8462.
Pharmacist Instructions for a Patient with an Eligible Third Party Payer: Submit the claim to the primary Third Party Payer first, then submit the balance due to Change Healthcare as a Secondary Payer COB [coordination of benefits] with patient responsibility amount and a valid Other Coverage Code, (e.g. 8). The patient is responsible for the first $9 and the card pays up to the next $150 on a monthly fill or $450 on a 90 day fill. Reimbursement will be received from Change Healthcare.
Pharmacist Instructions for a Cash-Paying Patient: Submit this claim to Change Healthcare. A valid Other Coverage Code (e.g. 1) is required. The patient is responsible for the first $9 and the card pays up to the next $150 on a monthly fill or $450 on a 90 day fill. Reimbursement will be received from Change Healthcare.
Valid Other Coverage Code required. For any questions regarding Change Healthcare online processing, please call the Help Desk at 1-800-422-5604.
Program expires 12/31/2021. Program managed by Connective RX on behalf of Amarin Pharma, Inc. The parties reserve the right to rescind, revoke or amend this offer without notice at any time. Not valid if reproduced. Void where prohibited by law, taxed or restricted
VAS-02058v3 August 2020