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THE TLANDO CO-PAY PROGRAM
A FOCUS ON SAVINGS.
Pay as Little as
$0 CO-PAY*
(*for eligible patients)

The cost of treatment shouldn’t keep you from taking TLANDO
The TLANDO Co-Pay Assistance Program can help reduce out-of-pocket expenses for your prescriptions.
You may pay as little as $0* for your TLANDO prescription
Patients can present this card at participating retail pharmacies for savings.
*Eligibility restrictions apply.
TLANDO Co-Pay Assistance Program – Terms and Conditions:
To The Patient: Present this card to your pharmacy along with a valid prescription for TLANDO. Commercially insured patients may pay as little as $0 on each monthly prescription. There is a cap on the amount of assistance patients can receive. Any remaining out-of-pocket expenses will be your responsibility once the maximum benefits have been applied. This offer is not transferable. By using this card, you acknowledge that you meet the eligibility criteria below and will comply with the terms and conditions. This card is not health insurance. If you have any questions regarding the TLANDO co-pay card, please call 1-347-503-0497.
Pharmacist Instructions for Commercially Insured Patient: When you use this card, you are certifying that you have not submitted and will not submit a claim for reimbursement under any federal, state or other governmental programs for this prescription. Submit the claim to the primary Third-Party Payer first, then submit the balance due as a Secondary Payer COB with patient responsibility amount and a valid Other Coverage Code, (e.g. 8, 3). The patient may pay as little as $0 on each monthly prescription and maximum benefits apply. Patients will be responsible for any remaining out-of-pocket expense once max benefits have been applied. By accepting this card and submitting claims for the TLANDO Support Program, you are certifying that you will comply with the Eligibility Restrictions below.
To the Pharmacist Only: For pharmacy questions, please call the Help Desk at 1-347-503-0497.
*Eligibility Restrictions: Offer only valid for patient with a valid prescription for TLANDO. Offer is valid for as long as patient is on therapy and may be subject to change. Maximum benefits apply. Offer not valid for prescription reimbursed under any federal or state healthcare program, including but not limited to, Medicare, Medicaid, TRICARE, Veterans Affairs, or any state medical assistance programs. Offer void where prohibited by law, taxed, or restricted. Offer only valid in the USA. Verity Pharma, Inc. reserves the right to rescind, revoke, or amend this offer at any time without notice. Patients agree to comply with any of the terms of their health insurance including any requirements to notify their insurance of any assistance received under this program. By using this co-pay assistance card, you demonstrate that you understand and agree to comply with the terms and conditions of this offer as put forth on this co-pay assistance card.