Coupon.pdf
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IMPORTANT SAFETY INFORMATION Vyvanse is a federally controlled substance (CII) because it can be abused or lead to dependence. Keep Vyvanse in a safe place to prevent misuse and abuse. Selling or giving away Vyvanse may harm others, and is against the law. SAFETY INFORMATION CONTINUED BELOW Print the Vyvanse Prescription Savings Offer now (or wait for it in your email). You can also opt to show it to the pharmacist using a wireless device. Take the Vyvanse prescription and the Vyvanse Prescription Savings Offer to the pharmacy. Keep the Vyvanse Prescription Savings Offer in a safe place and bring it to the pharmacy each time the prescription is filled. Vyvanse ® is for ADHD in patients 6 years and above, and for moderate to severe B.E.D. in adults. Vyvanse is not for weight loss. It is not known if Vyvanse is safe and effective for the treatment of obesity. Pay no more than $30 for up to 12 prescriptions up to a maximum savings of $60 per prescription.* Now you can instantly save on your Vyvanse prescription with the Vyvanse Prescription Savings Offer. Follow these steps to start saving: Thanks for registering. *Pay no more than $30 per prescription of Vyvanse (lisdexamfetamine dimesylate) for a maximum of up to $60 savings per prescription. The offer covers the amount above $30 up to a maximum of $60 savings per prescription. You will be responsible for any additional cost above $90 for each prescription. This offer is good for a maximum of 12 prescription fills and up to a total savings of $720. Offer expires . Restrictions may apply. Please see additional safety information on the following pages and accompanying Prescribing Information and Medication Guide and discuss with your doctor. ® 1/31/2016
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IMPORTANTSAFETYINFORMATION
Vyvanse isafederallycontrolledsubstance(CII)becauseitcanbeabusedorleadtodependence.KeepVyvanseinasafeplacetopreventmisuseandabuse.SellingorgivingawayVyvansemayharmothers,andisagainstthelaw.SAFETYINFORMATIONCONTINUEDBELOW
PrinttheVyvansePrescriptionSavingsOffernow(orwaitforitinyouremail).Youcanalsoopttoshowittothepharmacistusingawirelessdevice.
TaketheVyvanseprescriptionandtheVyvansePrescriptionSavingsOffertothepharmacy.
KeeptheVyvansePrescriptionSavingsOfferinasafeplaceandbringittothepharmacyeachtimetheprescriptionisfilled.
VyvanseisforADHDinpatients6yearsandabove,andformoderatetosevereB.E.D.inadults.Vyvanseisnotforweightloss.ItisnotknownifVyvanseissafeandeffectiveforthetreatmentofobesity.
Paynomorethan$30forupto12prescriptionsuptoamaximumsavingsof$60perprescription.*NowyoucaninstantlysaveonyourVyvanseprescriptionwiththeVyvansePrescriptionSavingsOffer.Followthesestepstostartsaving:
Thanksforregistering.
*Paynomorethan$30perprescriptionofVyvanse(lisdexamfetaminedimesylate)foramaximumofupto$60savingsperprescription.Theoffercoverstheamountabove$30uptoamaximumof$60savingsperprescription.Youwillberesponsibleforanyadditionalcostabove$90foreachprescription.Thisofferisgoodforamaximumof12prescriptionfillsanduptoatotalsavingsof$720.Offerexpires.Restrictionsmayapply.
PleaseseeadditionalsafetyinformationonthefollowingpagesandaccompanyingPrescribingInformationandMedicationGuideanddiscusswithyourdoctor.
1/31/2016
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BIN#:004682 PCN#:CN GRP#: ID#:Expirationdate:Limitoneofferperpatient.Maximum30capsulesperoffer.*Restrictionsmayapply.
Thissavingsoffercanbeappliedforinstantsavings.Patientsmaypaynomorethan$30onupto12prescriptionsforuptoamaximumof$60perprescription.Youmaysaveupto$720acrossall12fills.Validforupto30capsulesperprescription.ThisofferisnotvalidforprescriptionscoveredbyorsubmittedforreimbursementunderMedicaid,Medicare,orsimilarfederalorstateprogramsincludinganystatemedicalpharmaceuticalassistanceprogram.
PatientInstructions:Offerisgoodforoutofpocketexpensesthataregreaterthan$30.Ifyourcopayislessthan$30,thennodiscountisapplied.Ifitisbetween$30and$90,youonlypay$30.Ifyourtotaloutofpocketexpenseexceeds$90,youareresponsiblefortheadditionalbalance.Cashpayingpatientswilllikelypaygreaterthan$30fortheirprescription.Keepthissavingsofferandpresentitwitheachprescriptionforuptoamaximumof12prescriptionsoruntilofferexpires.Inordertoredeemthissavingsoffer,thepatientmusthaveavalidprescription.PrescriberID#requiredonprescription.Onlyonesavingsofferperpatient.Followthedosageinstructionsgivenbythedoctor.Thissavingsoffermaynotberedeemedforcash.Byparticipatinginthisprogram,youarecertifyingthatyouwillcomplywiththetermsandconditionsdescribedintheRestrictionssectionbelow.Offerexpires.Patientswithquestionsonthisofferpleasecall18664413469.
PharmacistinstructionsforapatientpayingwithanEligibleThirdParty:SubmittheclaimtotheprimaryThirdPartyPayerfirst,thensubmitthebalanceduetoTherapyFirstPlusasaSecondaryPayerCOB[coordinationofbenefits]withpatientresponsibilityamountandavalidOtherCoverageCode,(e.g.8).Thepatientisresponsibleforthefirst$30,andthesavingsofferpaysuptothenext$60.ReimbursementwillbereceivedfromTherapyFirstPlus.
Pharmacistinstructionsforacashpayingpatient:SubmitthisclaimtoTherapyFirstPlus.AvalidOtherCoverageCode(eg,1)isrequired.Thepatientisresponsibleforthefirst$30,andthesavingsofferpaysuptothenext$60.ReimbursementwillbereceivedfromTherapyFirstPlus.
ValidOtherCoverageCoderequired.ForanyquestionsregardingTherapyFirstPlusonlineprocessing,pleasecalltheHelpDeskat18004225604.
Restrictions:ThisofferisvalidintheUnitedStates.OffernotvalidforprescriptionsreimbursedunderMedicaid,aMedicaredrugbenefitplan,Tricareorotherfederalorstatehealthprograms(suchasmedicalassistanceprograms).Ifthepatientiseligibleforprescriptiondrugbenefitsunderanysuchprogram,thepatientcannotusethisoffer.Byusingthisoffer,thepatientcertifiesthatheorshewillcomplywithanytermsofhisorherhealthinsurancecontractrequiringnotificationtohisorherpayoroftheexistenceand/orvalueofthisoffer.Itisillegalto(orofferto)sell,purchase,ortradethisoffer.Thisofferisnottransferableandislimitedtooneofferperperson.Programexpires.
ProgrammanagedbyPSKW,LLConbehalfofShireUSInc.Thepartiesreservetherighttoamendorendthisprogramatanytime.Notvalidifreproduced.Voidwhereprohibitedbylaw.
PleaseseeadditionalsafetyinformationonthefollowingpagesandaccompanyingPrescribingInformationandMedicationGuideanddiscusswithyourdoctor.
EC31001310 287322305701/31/2016
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anxietydecreasedappetitediarrheadizziness
drymouthirritabilitylossofappetitenausea
troublesleepingupperstomachpainvomitingweightloss
drymouthtroublesleepingdecreasedappetite
increasedheartrateconstipationfeelingjittery
anxietyThemostcommonsideeffectsofVyvansereportedinstudiesofadultswithmoderatetosevereB.E.D.include:
IMPORTANTSAFETYINFORMATIONVyvanseisafederallycontrolledsubstance(CII)becauseitcanbeabusedorleadtodependence.KeepVyvanseinasafeplacetopreventmisuseandabuse.SellingorgivingawayVyvansemayharmothers,andisagainstthelaw.
Vyvanseisastimulantmedicine.Tellthedoctorifyouoryourchildhaveeverabusedorbeendependentonalcohol,prescriptionmedicines,orstreetdrugs.
WhoshouldnottakeVyvanse?DonottakeVyvanseifyouoryourchildis:
takingorhastakenanantidepressionmedicinecalledamonoamineoxidaseinhibitor(MAOI)withinthepast14days.sensitiveorallergicto,orhadareactiontootherstimulantmedicines.
ProblemsthatcanoccurwhiletakingVyvanse.Tellthedoctor:ifyouoryourchildhaveheartproblemsorheartdefects,highbloodpressure,orafamilyhistoryoftheseproblems.Thisisimportantbecausesuddendeathhasoccurredinpeoplewithheartproblemsordefects,andsuddendeath,strokeandheartattackhavehappenedinadults.Sinceincreasesinbloodpressureandheartratemayoccur,thedoctorshouldregularlychecktheseduringtreatment.Callthedoctorrightawayifyouoryourchildhaveanysignsofheartproblemssuchaschestpain,shortnessofbreath,orfaintingwhiletakingVyvanse.ifyouoryourchildhavementalproblems,orafamilyhistoryofsuicide,bipolarillness,ordepression.Thisisimportantbecauseneworworseningbehaviorandthoughtproblemsorbipolarillnessmayoccur.Newsymptomssuchasseeingorhearingthingsthatarenotreal,believingthingsthatarenottrue,beingsuspicious,orhavingnewmanicsymptomsmayoccur.Callthedoctorrightawayifthereareanyneworworseningmentalsymptomsduringtreatment.ifyouoryourchildhavecirculationproblemsinfingersandtoes(peripheralvasculopathy,includingRaynaudsphenomenon).Fingersortoesmayfeelnumb,cool,painful,sensitivetotemperatureand/orchangecolorfrompale,toblue,tored.CallthedoctorrightawayifanysignsofunexplainedwoundsappearonfingersortoeswhiletakingVyvanse.ifyourchildishavingslowingofgrowth(heightandweight)Vyvansemaycausethisserioussideeffect.YourchildshouldhavehisorherheightandweightcheckedoftenwhiletakingVyvanse.Thedoctormaystoptreatmentifaproblemisfoundduringthesecheckups.ifyouoryourchildarepregnant,breastfeeding,orplantobecomepregnantorbreastfeed.
WhatarepossiblesideeffectsofVyvanse?ThemostcommonsideeffectsofVyvansereportedinADHDstudiesinclude:
WhatisVyvanse?Vyvanse(lisdexamfetaminedimesylate)isaprescriptionmedicineusedforthetreatmentofAttentionDeficit/HyperactivityDisorder(ADHD)inpatients6yearsandabove,andforthetreatmentofmoderatetoseverebingeeatingdisorder(B.E.D.)inadults.Vyvanseisnotforweightloss.ItisnotknownifVyvanseissafeandeffectiveforthetreatmentofobesity.
Foradditionalsafetyinformation,clickhereforPrescribingInformationandMedicationGuideanddiscusswithyourdoctor.
YouareencouragedtoreportnegativesideeffectsofprescriptiondrugstotheFDA.Visitwww.fda.gov/medwatch,orcall1800FDA1088.
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VyvanseisaregisteredtrademarkofShireLLC.2015P.S.K.W.Associates,PatentPending2015ShireUSInc.,Wayne,PA19087.Allrightsreserved.
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