Terms and Conditions
PERTZYE® (pancrelipase) Co-Pay Assistance Program
Chiesi CareDirect Hub Co-pay: Patients may pay as little as $0 for their prescription utilizing one of the below options:
- Fill at a Specialty Pharmacy contracted with Chiesi. To access a list of participating pharmacies, visit https://resources.chiesiusa.com/Pertzye/PERTZYE_Specialty_Pharmacy_List.pdf
- Enroll in Chiesi CareDirect if filling prescription at a retail pharmacy or non-contracted Specialty Pharmacy.
- To access a list of participating pharmacies, visit https://resources.chiesiusa.com/Pertzye/PERTZYE_Specialty_Pharmacy_List.pdf
- To enroll in Chiesi CareDirect, please click here to complete the enrollment form online. For more information on Chiesi CareDirect, click here.
Retail Co-pay Program: Patients may pay as little as $20 for their prescription at most retail pharmacies. Chiesi partners with Relay Health® participating pharmacies to reduce co-pays for eligible patients.*
To locate a pharmacy in the area that participates in Relay Health, please visit https://evoucherrx.relayhealth.com/storelookup.
- The Retail Co-Pay program does not require Chiesi CareDirect enrollment. Please note that should the patient enroll in the Chiesi CareDirect, they may be eligible for a co-pay assistance program that may offer as little as $0 co-pay for eligible patients, while still utilizing their retail pharmacy.
- To enroll in Chiesi CareDirect, please click here to complete the enrollment form online. For more information on Chiesi CareDirect, click here.
PERTZYE Co-Pay Assistance Program Eligibility
- The PERTZYE Co-Pay Assistance Program is available to PERTZYE patients using the product to treat exocrine pancreatic insufficiency (EPI) due to Cystic Fibrosis. To access support for EPI due to other conditions, please visit the PERTZYE® Care Program.
- Patient must have commercial insurance and a valid prescription for a US Food and Drug Administration (FDA)-approved indication for PERTZYE.
- Click here to view Prescribing Information.
- Patient must be a resident of the United States or one of its territories.
*Please refer to the full Terms and Conditions below for additional eligibility requirements.
PERTZYE Co-Pay Assistance Program Terms and Conditions
The PERTZYE Co-Pay Assistance Program (the “Co-pay Program”) may pay for eligible out-of-pocket medication, up to $17,280 per calendar year. After reaching the maximum Co-pay Program benefit, the patient will be responsible for any remaining out-of-pocket costs incurred during that calendar year.
The Co-pay Program is valid only for patients with commercial insurance who have a valid prescription for a US Food and Drug Administration (FDA)-approved indication for the product. A patient who receives health care benefits under any plan or program funded in whole or in part by federal or state governments including Medicare, Medicaid, TRICARE, Veterans Affairs (VA), State Prescription Assistance Plans (SPAPs) (other than health insurance for federal government employees) or any state health care program such as Medicaid, Children’s Health Insurance Program, programs funded under Maternal and Child Health Program or programs funded under Social Services Block Grant are not eligible for the Co-pay Program. A patient covered under a commercial health plan purchased through a health insurance marketplace or exchange is not a Government Program Beneficiary even if the costs of such coverage are subsidized by the federal government. If at any time a patient begins receiving prescription drug coverage under any such federal, state, or government-funded healthcare program, the patient will no longer be able to participate in the Co-pay Program and the patient must notify the filling pharmacy to stop participation or Chiesi CareDirect.
To enroll in the Co-pay Program, the patient must also be a resident of the US or one of its territories. If the Patient is incapable of acting on their own behalf or if the Patient is under 18 years old, enrollment into the Co-pay Program may be completed by another person acting on their behalf (such as a caregiver).
Patients residing in or receiving treatment in certain states may not be eligible for the Co-pay Program. Co-pay Program not available in California or Massachusetts when an AB-rated equivalent to the product is commercially available. Patients may not seek reimbursement for value received from the Co-pay Program. The Co-pay Program does not obligate the use of any specific medication or health care provider. Participation in the Co-pay Program is not conditioned on any past, present, or future purchase.
The Co-pay Program benefits may not be sold, purchased, traded, or offered for sale, purchase, or trade. The Co-pay Program is not valid where prohibited by law, taxed, or otherwise restricted. Offer subject to change or discontinuance without notice. Restrictions, including monthly maximums, may apply. This is not health insurance.
This is a voluntary program. Patients who choose not to enroll in the Co-pay Program will still be able to receive medication. Patients may participate in Chiesi CareDirect without participating in the Co-pay Program. After enrolling in the Co-pay Program or in Chiesi CareDirect, participants may opt out by contacting Chiesi CareDirect, as outlined in the Consent and HIPAA Authorization section of the Chiesi CareDirect Service Request and Prescription Form or by calling the filling pharmacy. Patients must renew their eligibility by December 31 of each year to continue to receive support under the Co-pay Program.
By participating in the Co-pay Program, participants acknowledge that they understand and agree to comply with these Terms and Conditions.
PERTZYE Chiesi CareDirect Patient Assistance Program Eligibility and Terms and Conditions
- Patient must be enrolled in Chiesi CareDirect. To enroll, please click here. For additional details, please see the Chiesi CareDirect Patient Assistance Program Application.
- Patient has a valid prescription for a US Food and Drug Administration (FDA)-approved indication for PERTZYE. To access Prescribing Information for PERTZYE® click here.
- Patient does not receive health care benefits from a federal or state-funded plan or program. Patients with Medicare Part D may be eligible for this program. Please see additional requirements for Medicare Part D patients below.
- Patient is uninsured or underinsured (lack of coverage for their medication)
- If patient has commercial insurance, they may be eligible for the PERTZYE $0 Co-Pay Assistance Program.*
- Patient must have an annual household income that does not exceed 450% of the current Federal Poverty Level (FPL)*
- Click here to access current FPL guidelines in the United States (US) and its territories.
- Patient must be a resident of the US or one of its territories.
*Please refer to the full Terms and Conditions below for additional eligibility requirements.
Qualified patients may be eligible to receive their medication at no cost through the Chiesi CareDirect Patient Assistance Program (“Patient Assistance Program”). Financial eligibility of uninsured or underinsured patients who are permanent residents of the United States or one of its territories will be determined by the US Federal Poverty Guidelines https://aspe.hhs.gov/poverty-guidelines. Patient must attest that no change in their income has occurred and a verification of coverage will occur before each prescription fill. Patient must notify Chiesi CareDirect if there is a change in their insurance or their prescription drug plan.
A patient who receives health care benefits under any plan or program funded in whole or in part by federal or state governments including Medicaid, TRICARE, Veterans Affairs (VA), State Prescription Assistance Plans (SPAPs) (other than health insurance for federal government employees) or any state health care program such as Medicaid, Children’s Health Insurance Program, programs funded under Maternal and Child Health Program or programs funded under Social Services Block Grant are not eligible for the Patient Assistance Program. A patient covered under a commercial health plan purchased through a health insurance marketplace or exchange is not a Government Program Beneficiary even if the costs of such coverage are subsidized by the federal government. Medicare Part D Patients: A patient receiving health care benefits under a Medicare Part D, and if approved for assistance under the Patient Assistance Program, agrees that they will not apply the cost of PERTZYE (the “Product”), toward any insurance benefit or seek reimbursement for the cost of the Product received under the program from the insurer. Patient also agrees that they will not seek to have the Product, or any cost associated with the Product applied towards true out-of-pocket (“TrOOP”) costs. Patient understands that eligible Medicare Part D enrollees will receive the Product at no charge under the Patient Assistance Program for the remainder of the current calendar year. Patient also understands that Chiesi CareDirect will notify the Medicare Part D plan that the patient is receiving the Product at no charge under the program and no payments should be made for the Product by the Medicare Part D Plan and no part of the costs of the Product should be applied toward the TrOOP accrued by the patient. This notice is provided for plan information purposes – Chiesi CareDirect will never submit a claim for Product provided under the program to the patient’s Medicare Part D plan.
To enroll in the Patient Assistance Program, the patient must also enroll in Chiesi CareDirect, a patient services support program offered by Chiesi. The patient must also be a resident of the US or one of its territories. If the Patient is incapable of acting on their own behalf or if the Patient is under 18 years old, enrollment into Chiesi CareDirect may be completed by another person acting on their behalf (such as a caregiver).
If at any time a patient begins receiving prescription drug coverage under any such federal, state, or government-funded healthcare program, patient will no longer be able to participate in the Patient Assistance Program and patient must notify Chiesi CareDirect to stop participation.
To determine financial eligibility, patient will be asked to provide the size of the household, annual household income, and proof of income. Proof of income may include W2 form(s), paycheck stubs, and/or prior year tax returns.
Patients residing in or receiving treatment in certain states may not be eligible for the Patient Assistance Program. Patients may not seek reimbursement for value received from Chiesi CareDirect or from the Patient Assistance Program. The Patient Assistance Program does not obligate the use of any specific medication or health care provider. Participation in the Patient Assistance Program is not conditioned on any past, present, or future purchase.
The Patient Assistance Program benefits may not be sold, purchased, traded, or offered for sale, purchase, or trade. The Patient Assistance Program is not valid where prohibited by law, taxed, or otherwise restricted. Offer subject to change or discontinuance without notice. Restrictions may apply. This is not health insurance.
This is a voluntary program. Patients who choose not to enroll in the Patient Assistance Program will still be able to receive medication. Patients may participate in Chiesi CareDirect without participating in the Patient Assistance Program. After enrolling in the Patient Assistance Program or in Chiesi CareDirect, participants may opt out by contacting Chiesi CareDirect, as outlined in the Chiesi CareDirect Enrollment and Authorization Form. Patients must renew their eligibility by December 31 of each year to continue to receive support under the Patient Assistance Program.
By participating in the Patient Assistance Program, participants acknowledge that they understand and agree to comply with these Terms and Conditions.
PERTZYE Chiesi CareDirect Affordability Solutions Support Services Program Eligibility
Patient must be enrolled in Chiesi CareDirect.
Patient has commercial insurance and a valid prescription for a US Food and Drug Administration (“FDA”)-approved indication for PERTZYE.
Patient must be a resident of the United States or one of its territories.
Please refer to the full Terms and Conditions below for additional eligibility requirements.
TERMS AND CONDITIONS FOR PERTZYE CHIESI CAREDIRECT AFFORDABILITY SOLUTIONS SUPPORT SERVICES PROGRAM
Chiesi CareDirect Affordability Solutions Support Services Program, a patient services support program offered by Chiesi, helps patients navigate their insurance through assisting the patient with prior authorization, appeals, and other coverage determination delays. A Chiesi CareDirect Reimbursement Case Advocate may offer information on independent charitable foundations that potentially have funds for the patient’s disease state. (Note: Chiesi does not financially support any independent charitable foundation funds. Chiesi CareDirect may not assist the patient with their enrollment in an independent charitable foundation. Patients will have to determine if they are eligible for independent charitable foundation support.)
To receive support services, the patient must also enroll in Chiesi CareDirect. The patient must also be a resident of the US or one of its territories. If the patient is incapable of acting on their own behalf or if the patient is under 18 years old, enrollment into Chiesi CareDirect may be completed by another person acting on their behalf (such as a caregiver).
This is a voluntary program. Patients who choose not to enroll in the Chiesi CareDirect Program will still be able to receive medication. Patients may participate in Chiesi CareDirect without participating in the Affordability Solutions Support Services Program. After enrolling in Chiesi CareDirect, participants may opt out by contacting Chiesi CareDirect, as outlined in the Consent and HIPAA Authorization section of the Chiesi CareDirect Service Request and Prescription Form.
Supply of product when there is a delay in coverage determination is known as “bridging” and is valid only for patients with commercial insurance who have a valid prescription for a US Food and Drug Administration-approved indication for the product. Eligible patients may receive a limited supply of PERTZYE if experiencing a delay of 5 business days or more in coverage determination through the PERTZYE QuickStart Program.
Patients who receive health care benefits under any plan or program funded in whole or in part by federal or state governments including Medicare, Medicaid, TRICARE, Veterans Affairs (VA), State Prescription Assistance Plans (SPAPs) (other than health insurance for federal government employees) or any state health care program such as Medicaid, Children’s Health Insurance Program, programs funded under Maternal and Child Health Program or programs funded under Social Services Block Grant are not eligible for the QuickStart Program. A patient covered under a commercial health plan purchased through a health insurance marketplace or exchange is not a Government Program Beneficiary even if the costs of such coverage are subsidized by the federal government.
To receive product under the QuickStart Program, the patient must also enroll in Chiesi CareDirect, a patient services support program offered by Chiesi. The patient must also be a resident of the US or one of its territories. If the patient is incapable of acting on their own behalf or if the patient is under 18 years old, enrollment into Chiesi CareDirect may be completed by another person acting on their behalf (such as a caregiver).
Patient must be naïve to PERTZYE, meaning the patient cannot have previously filled a prescription for PERTZYE. The patient must be actively pursuing coverage and not be delayed due to patient or healthcare provider inactivity.
The QuickStart Program benefits may not be sold, purchased, traded, or offered for sale, purchase, or trade. The QuickStart Program is not valid where prohibited by law, taxed, or otherwise restricted. Offer subject to change or discontinuance without notice. Restrictions may apply. This is not health insurance.
By participating in Chiesi CareDirect Affordability Solutions Support Services Program, participants acknowledge that they understand and agree to comply with these Terms and Conditions.
PERTZYE Chiesi CareDirect Wellness Program Program Eligibility
- Patient must be enrolled in Chiesi CareDirect.
- Patient has a valid and eligible prescription for a US Food and Drug Administration (FDA)-approved indication for eligible Cystic Fibrosis products marketed by Chiesi USA (see all Chiesi USA products here).
- Patient must be a resident of the United States or one of its territories.
- Patient must submit valid proof of prescription purchase via email, fax or mail to Chiesi CareDirect with each product refill.
- Email: Chiesicaredirect@caremetx.com
- Fax: 866-410-6241
- Mail: 6931 Arlington Rd #308, Bethesda, MD 20814
Please see full terms and conditions below.
Chiesi CareDirect Wellness Program Terms and Conditions
The Chiesi CareDirect Wellness Program (the “Wellness Program”) provides points with each eligible prescription to be used on wellness items. Eligible patients may elect to receive monthly vitamins and supplements in lieu of points. Patients may select a preference at the time that proof of purchase is submitted to Chiesi CareDirect. Eligible patients may not elect to receive both points and a vitamin subscription during the same monthly cycle. Patient may change preferences by utilizing the Chiesi CareDirect Wellness Program store front.
The Wellness Program is valid only for patients with commercial insurance who have a valid prescription for a US Food and Drug Administration-approved indication for the product. A patient who receives health care benefits under any plan or program funded in whole or in part by federal or state governments including Medicare, Medicaid, TRICARE, Veterans Affairs (VA), State Prescription Assistance Plans (SPAPs) (other than health insurance for federal government employees) or any state health care program such as Medicaid, Children’s Health Insurance Program, programs funded under Maternal and Child Health Program or programs funded under Social Services Block Grant are not eligible for the Wellness Program. A patient covered under a commercial health plan purchased through a health insurance marketplace or exchange is not a Government Program Beneficiary even if the costs of such coverage are subsidized by the federal government. Patients participating in the Chiesi CareDirect Patient Assistance Program are not eligible for the Wellness Program.
To enroll in the Wellness Program, the patient must enroll in Chiesi CareDirect, a patient services support program offered by Chiesi. The patient must also be a resident of the US or one of its territories. If the Patient is incapable of acting on their own behalf or if the Patient is under 18 years old, enrollment into Chiesi CareDirect may be completed by another person acting on their behalf (such as a caregiver).
If at any time a patient begins receiving prescription drug coverage under any such federal, state, or government-funded health care program, patient will no longer be able to participate in the Wellness Program and patient must notify Chiesi CareDirect to stop participation.
The Wellness Program benefits may not be sold, purchased, traded, or offered for sale, purchase, or trade. The Wellness Program is not valid where prohibited by law, taxed, or otherwise restricted. Offer subject to change or discontinuance without notice. Restrictions, including monthly maximums, may apply. This is not health insurance.
This is a voluntary program. Patients who choose not to enroll in the Wellness Program will still be able to receive medication. Patients may participate in Chiesi CareDirect without participating in the Wellness Program. After enrolling in the Wellness Program or in Chiesi CareDirect, participants may opt out by contacting Chiesi CareDirect, as outlined in the Consent and HIPAA Authorization section of the Chiesi CareDirect Service Request and Prescription Form. Patients must renew their eligibility by December 31 of each year to continue to receive support under the Wellness Program.
By participating in the Wellness Program, participants acknowledge that they understand and agree to comply with these Terms and Conditions.
PERTZYE Patient Concierge App
If you have been prescribed PERTZYE by your Healthcare Provider, the PERTZYE Concierge App (the “App”) can help you access the Chiesi CareDirect Wellness Program, complete Chiesi CareDirect enrollment forms, and access educational resources.
Patients or their caregivers may elect to download the App by visiting pertzyecares.com.
Patients may use the App to:
- Easily fill out Chiesi CareDirect Service Request and HIPAA Consent Forms
- Submit proofs of prescription purchase to earn monthly vitamins and supplements or wellness points through the Chiesi CareDirect Wellness Program1
- View submission or eligibility status
- Access and redeem Chiesi CareDirect Wellness Program items1
Patients participating in government-funded plans are not eligible for the Chiesi CareDirect Wellness Program.
Please see full terms and conditions below.
PERTZYE Concierge App Terms and Conditions
The PERTZYE Concierge App (the “App”) is available to eligible patients who have a valid prescription for a US Food and Drug Administration-approved indication for PERTZYE.
This is a voluntary program. Patients who choose not to download the PERTZYE Concierge App will still be able to receive medication. Patients may participate in Chiesi CareDirect, a patient services support program offered by Chiesi, without utilizing the PERTZYE Concierge App. After downloading the PERTZYE Concierge App or enrolling in Chiesi CareDirect, participants may opt out by contacting Chiesi CareDirect, as outlined in the Consent and HIPAA Authorization section of the Chiesi CareDirect Service Request and Prescription Form.
To utilize the PERTZYE Concierge App, the patient must enter a phone number into the widget on the website or enroll in Chiesi CareDirect. The patient must also be a resident of the US or one of its territories. If the Patient is incapable of acting on their own behalf or if the Patient is under 18 years old, enrollment into Chiesi CareDirect may be completed by another person acting on their behalf (such as a caregiver).
By downloading the PERTZYE Concierge App, participants acknowledge that they understand and agree to comply with these Terms and Conditions.