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Co-pay Coupon Program Enrollment

Important:

To complete co-pay enrollment for the authorized generic of EPCLUSA® (sofosbuvir 400 mg/velpatasvir 100 mg tablets) or the authorized generic of HARVONI® (ledipasvir 90 mg/sofosbuvir 400 mg tablets), please visit the Asegua co-pay enrollment website; to enroll by phone, please call 1-855-7-MYPATH (1-855-769-7284).

To enroll in the SOVALDI® (sofosbuvir 400 mg tablets) Co-pay Coupon program, please call 1-855-7-MYPATH (1-855-769-7284).

To enroll in any product by phone, please call 1-855-7-MYPATH (1-855-769-7284).

Note: For the questions that follow, please provide the patient's information.

Eligibility

For coverage information or financial support, call 1-855-7-MYPATH (1-855-769-7284).

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Information

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Marketing Communications Opt-In (OPTIONAL):

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Co-pay Coupon

Thank you for your enrollment in the Gilead Co-pay Coupon program. You have taken the first step toward saving on your prescription.

Next step: To start saving, provide the below co-pay coupon information and your prescription to the pharmacy to fill your prescription.

Coupon valid for 6 months after first redemption

RxBIN: [XXXXXX]

RxPCN: [XXXXXX]

RxGRP: [XXXXXX]

ISSUER: [XXXXXX]

ID #: [XXXXXX]

[ProductName]

[ProductLongName]

Not valid for patients enrolled in government healthcare prescription
drug programs. See Terms and Conditions.
Download Co-pay Coupon

When filling your prescription, be sure to have your co-pay coupon and prescription available, as the pharmacist will need this information to complete your request. Your prescription may need to be filled at a specialty pharmacy.

If you have any questions, please contact a Support Path® program specialist at 1-855-769-7284, Monday through Friday from 9 AM to 8 PM Eastern Time.

Questions?

We're here to help. Call 1-855-7-MYPATH to speak with a Support Path® program specialist.

Coupon Benefits

  • Subject to the Gilead Support Path® Co-pay Coupon (“Coupon”) Terms and Conditions, this program provides the following financial assistance for the out-of-pocket costs for eligible commercially insured patients with a valid prescription:
    • Up to a maximum of 25% of the catalog price for three bottles in cost-sharing assistance, valid for 6 months from the time of first redemption with no monthly limit for the following products:
      • EPCLUSA® (sofosbuvir 400 mg/velpatasvir 100 mg)
      • HARVONI® (ledipasvir 90 mg/sofosbuvir 400 mg)
      • SOVALDI® (sofosbuvir 400 mg)
      • VOSEVI® (sofosbuvir
        400 mg/velpatasvir 100 mg/voxilaprevir 100 mg)
    • Up to a maximum of $6,000 in cost-sharing assistance per calendar year with no monthly limit for the following product:
      • VEMLIDY® (tenofovir alafenamide 25 mg)
    • Up to a maximum of $10,000 in cost-sharing assistance per calendar year with no monthly limit for the following product:
      • LIVDELZI® (seladelpar 10 mg)
  • As described in the Coupon Terms and Conditions, Gilead may reduce or discontinue the financial assistance available under the Coupon if it determines the patient is subject to an “accumulator adjustment” or “co-pay maximizer” program.
    • If Gilead determines that a patient’s insurer (or its agent) has implemented a program that adjusts patient cost-sharing obligations based on the availability of support under the Coupon program (sometimes called a “co-pay maximizer program”), unless prohibited by law, Gilead may reduce or discontinue the cost-sharing assistance available under the Coupon after providing assistance in an amount not to exceed the lesser of $9,500 or current maximum limit.
    • If Gilead determines that a patient’s insurer (or its agent) has implemented a program that excludes the financial assistance provided under the Coupon program from counting towards the patient’s deductible or out-of-pocket cost limitations (sometimes called an “accumulator adjustment program”), unless prohibited by law, Gilead may reduce the cost-sharing assistance available under the Coupon to a per claim maximum of $25. Please contact Support Path at 1-855-769-7284 to determine if additional cost-sharing assistance is available.
  • These Coupon benefits are subject to change for any reason at any time without notice.

Gilead Support Path® Co-pay Coupon Terms and Conditions:

  • The Gilead Support Path Co-pay Coupon (“Coupon”) provides financial assistance for the out-of-pocket costs for eligible commercially insured patients as described in the Coupon Benefits above. Coupon benefits are limited to financial assistance for patient cost-sharing for the applicable Gilead product only.
  • The Coupon can be used only by eligible residents of the US, Puerto Rico, or US territories at participating eligible pharmacies in the US, Puerto Rico, or US territories. Product must be dispensed in the US, Puerto Rico, or US territories. Individuals must be at least 18 years old to use the Coupon themselves or to enroll in the Coupon on behalf of a minor.
  • To use the Coupon, the patient (or the patient’s legal representative on behalf of the patient, as applicable) must personally complete the enrollment process for the Coupon. Third-party payers, pharmacy benefit managers, or the agents of either, are prohibited from assisting patients with enrolling in the Coupon. Any decision to enroll in the Coupon must be made voluntarily by the patient.
  • The Coupon is not insurance and is not intended to substitute for insurance. Uninsured and cash-paying patients are not eligible to use the Coupon. The Coupon is valid only for prescriptions that are reimbursed by commercial insurance and is not valid for prescriptions that are eligible to be reimbursed:
    • in whole or in part by Medicare or a Medicare Part D plan, Medicaid, TRICARE, VA, DOD, Puerto Rico Government Health Insurance Plan, or any other state or federally funded healthcare benefit program (collectively, “Government Programs”); or
    • by commercial plans or other health or pharmacy benefit programs that reimburse for the entire cost of prescription drugs or prohibit the Coupon’s use.
  • Patients who begin receiving prescription benefits from Government Programs at any time must notify Gilead of this fact by contacting Support Path at 1-855-769-7284 and will no longer be eligible to use the Coupon.
  • The Coupon is limited to one per person and is not transferable. No substitutions are permitted. This Coupon is offered to, and intended for the sole benefit of, eligible patients and may not be utilized for the benefit of third parties, including, without limitation, third-party payers, pharmacy benefit managers, or the agents of either. If Gilead determines that a patient’s insurer has implemented a program that adjusts patient cost-sharing obligations based on the availability of support under the Coupon program (sometimes called a “co-pay maximizer program”), unless prohibited by law, Gilead may reduce or discontinue the cost-sharing assistance available under the Coupon after providing assistance in an amount not to exceed the lesser of $9,500 or current maximum limit. If Gilead determines that a patient’s insurer has implemented a program that excludes the financial assistance provided under the Coupon program from counting towards the patient’s deductible or out-of-pocket cost limitations (sometimes called an “accumulator adjustment program”), unless prohibited by law, Gilead may reduce the cost-sharing assistance available under the Coupon to a per claim maximum of $25. Patients may contact Support Path at 1-855-769-7284 to determine if additional cost-sharing assistance is available.
  • The Coupon is only available with a valid prescription. No other purchase is necessary to redeem this offer.
  • The Coupon cannot be combined with any other coupon, free trial, discount, prescription savings card, or other offer (including, without limitation, any program offered by a third-party payer or pharmacy benefit manager, or an agent of either, that adjusts patient cost-sharing obligations). Patients are not eligible to use the Coupon for a product if they are currently receiving free drug assistance through Gilead Sciences, Inc. (“Gilead”)’s patient assistance program for that product.
  • The Coupon will not reimburse any payments made by Flexible Spending Account (FSA), Health Savings Account (HSA), Health Reimbursement Account (HRA), or any other payor, discount/co-pay program, or other offer.
  • Void where prohibited by law, taxed, or restricted.
  • Patient, pharmacist, and prescriber agree not to seek reimbursement for all, or any part of the benefit received by the patient through the Coupon. Both patient and pharmacist are each individually responsible for reporting receipt of the Coupon benefit to any insurer, health plan, or other third party who pays for or reimburses any part of the prescription filled using the Coupon, as may be required.
  • It is illegal to sell, purchase, trade, or counterfeit, or offer to sell, purchase, trade, or counterfeit the Coupon.
  • Certain information pertaining to your use of the Coupon will be shared with Gilead, the sponsor of the Coupon, and its affiliates. The information disclosed will include the patient co-pay ID, pharmacy demographics, prescriber information, and details relating to the coupon claim, such as co-pay amount, insurance details, and the therapy received. For more information, please see the Gilead Privacy Policy at www.gilead.com/privacy-statements.
  • Gilead Sciences reserves the right to terminate, rescind, revoke, or modify the Coupon for any reason at any time without notice.
Need help? Connect live with a Support Path® program specialist at 1-855-7-MYPATH (1-855-769-7284) Monday-Friday, 9 AM to 8 PM ET.