Delstrigo or Pifeltro Savings Coupon

Funded

About

The Delstrigo or Pifeltro Savings Coupon program offers significant financial benefits for eligible patients, providing cost relief for Pifeltro and Delstrigo prescriptions. This program allows privately insured patients to potentially pay as little as $0 for their medication by offering up to $6,800 in savings on out-of-pocket expenses. The Delstrigo or Pifeltro Savings Coupon program is designed to ease the financial burden of treatment for patients meeting specific eligibility criteria.

Insurance requirements: Commercially insured, Underinsured

Enrollment Forms

Enrollment Form

Benefits

•$6800 annual maximum benefit

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: Yes

Program Details

•Eligible privately insured patients may pay as little as $0

•Coupon provides savings on outofpocket cost, up to a maximum total program savings of $6,800

•Coupon is valid for up to 90 day supply tablets per prescription fill; Coupon may be redeemed only once every 21 days

•Coupon can be printed and activated for immediate use following online enrollment and eligibility questions

•If patients are unable to redeem this coupon at their eligible retail or mailorder pharmacy, please keep receipt and call McKesson Corporation at 877‑264‑2454 within 30 days of purchase to request a Direct Member Reimbursement (DMR) form

•Please note: Not all patients will be eligible for Direct Member Reimbursement, and Merck may discontinue this at any time without notice

•For pharmacy processing questions, call the McKesson Help Desk at 877‑264‑2454 (8 AM8 PM ET, MondayFriday)

Enrollment Forms

Enrollment Form

Other Programs

Good Days: HIV, AIDS Treatment & Prevention

Commercially Insured

Medicare / Medicaid

Underinsured

Uninsured

Max Saving: $2000/year*

Merck Patient Assistance Program: Pifeltro

Commercially Insured

Medicare / Medicaid

Underinsured

Uninsured

Pay as low as

$0/ fill

Other Tools for Pifeltro

Get patient education materials