Nuplazid Free Trial Offer

Funded

About

The Nuplazid Free Trial Offer provides patients with an opportunity to try Nuplazid at no cost for 14 days. This exclusive program, designed for eligible patients diagnosed in line with the FDA-approved use of Nuplazid, aims to facilitate access to this important medication. Through the Nuplazid Free Trial Offer, patients receive a 14-day supply either in capsule or tablet form, ensuring they can explore the benefits of Nuplazid in managing their condition, with easy enrollment via Acadia Connect.

Insurance requirements: Commercially insured, Underinsured, Uninsured

Enrollment Forms

Enrollment Form

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Must be 18 years of age or older

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: No

•Activation Required: No

Program Details

•Eligible patients can receive a 14day free trial shipped to their home

•Patient must be enrolled in Acadia Connect in order to receive the free 14day supply

•HCP can enroll patient online, or download PDF enrollment form and fax to 8447372224 or email to acadiaconnect@acadiapharm.com

•PDF form can be downloaded from: https://www.acadiaconnect.com/pdf/treatmentformnuplazid.pdf

•NUPLAZID Free 14Day Supply is available in either the recommended dose of 34 mg capsules or 10 mg tablets taken oncedaily for 14 days

•NUPLAZID Free 14Day Supply is dispensed by RareMed Pharmacy; all remaining prescriptions will be dispensed by an innetwork specialty pharmacy

•NUPLAZID Free 14Day Supply may only be shipped to a physical address within the United States or its Territories. Product will not be shipped to a PO box

•Patients can also enroll for a $0 copay program following this free trial on the same enrollment form

•Some patients may be eligible to receive a second NUPLAZID Free 14Day Supply if it is determined that such a shipment is necessary to keep a patient on NUPLAZID due to a confirmed delay with their commercial product shipment of NUPLAZID

•Call 8447372223, Mon.–Fri., 8:00 am to 8:00 pm ET, for assistance or additional information

Enrollment Forms

Enrollment Form

Other Programs

Acadia Connect Copay Assistance Program: Nuplazid

Commercially Insured

Medicare / Medicaid

Underinsured

Uninsured

Pay as low as

$0/ fill

Acadia Connect Patient Assistance Program: Nuplazid