Save on Rhopressa®

Reduce the cost of your prescription from the start* with the Rhopressa® Savings Card!

Pay as little as 20*

with eligible commercial insurance

Pay as little as 50*

with eligible commercial insurance where Rhopressa® is not covered

Download the Rhopressa® Savings Card and present it to your pharmacist with your prescription

Get your card now

*Restrictions apply. Patients with State or Federal coverage, such as Medicare or Medicaid, are excluded. See terms and conditions.

Patient Instructions: In order to redeem this offer you must have a valid prescription for Rhopressa®. This offer may not be redeemed for cash. By using this offer, you are certifying that you meet the eligibility criteria and will comply with the terms and conditions described in the Restrictions section below. Patients with state or federal coverage, such as Medicare or Medicaid, are excluded. Patients with questions about the Rhopressa® Savings offer should call 1-844-807-9706.

Eligible commercially insured patients with coverage for Rhopressa® will pay the first $20 and receive up to $65 off the patient’s co-pay for a 30-day supply. Offer valid up to 12 uses.

Eligible commercially insured patients who are not covered for Rhopressa® will pay the first $50 and receive up to $200 off the patient’s out of pocket expenses per 30-day supply of Rhopressa®. Offer valid for up to 3 uses.

Pharmacist instructions: Commercial insurance coverage for Rhopressa®: Submit the claim to the primary commercial insurance company first, then submit the balance due to CHANGE HEALTHCARE as a Secondary Payer COB with patient responsibility amount and a valid Other Coverage Code, (e.g. 8). The patient is responsible for the first $20 and the card pays up to the next $65. Reimbursement will be received from CHANGE HEALTHCARE.

Pharmacist instructions: Commercially insured but not covered: Submit this claim to CHANGE HEALTHCARE. A valid Other Coverage Code (e.g. 1, 3) is required. The patient is responsible for the first $50 and the card pays up to the next $200. Reimbursement will be received from CHANGE HEALTHCARE.

For any questions regarding CHANGE HEALTHCARE online processing, please call the Help Desk 1-800-433-4893.

Restrictions: This offer is valid for eligible residents of the United States only. Patients with state or federal coverage, such as Medicare or Medicaid, are excluded. Offer may not be combined with any savings, discount, trial or similar offer for the same prescription. By using this offer, the patient certifies that he or she will comply with any terms of his or her health insurance contract requiring notification to his or her payor of the existence and/or value of this offer. Offer not valid for patients under 18 years of age. It is illegal to (or offer to) sell, purchase, or trade this offer. Program expires 12/31/2018. This offer is not transferable. Void where prohibited by law. Program managed by ConnectiveRx on behalf of Aerie Pharmaceuticals. Aerie Pharmaceuticals reserves the right to rescind, revoke or amend this offer without notice at any time.

BY USING THIS CARD, YOU AND YOUR PHARMACIST UNDERSTAND AND AGREE TO COMPLY WITH THESE ELIGIBILITY REQUIREMENTS AND TERMS OF USE.

IMPORTANT SAFETY INFORMATION

Dosage and Administration: Twice a day dosing is not well tolerated and is not recommended. If RHOPRESSA® is to be used concomitantly with other topical ophthalmic drug products to lower IOP, administer each drug product at least 5 minutes apart.

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IMPORTANT SAFETY INFORMATION

Dosage and Administration: Twice a day dosing is not well tolerated and is not recommended. If RHOPRESSA® is to be used concomitantly with other topical ophthalmic drug products to lower IOP, administer each drug product at least 5 minutes apart.

Warnings and Precautions:

Bacterial Keratitis - There have been reports of bacterial keratitis associated with the use of multiple-dose containers of topical ophthalmic products. These containers had been inadvertently contaminated by patients who, in most cases, had a concurrent corneal disease or a disruption of the ocular epithelial surface.

Adverse reactions: The most common ocular adverse reaction observed in controlled clinical studies with RHOPRESSA® dosed once daily was conjunctival hyperemia which was reported in 53% of patients. Other common (approximately 20%) adverse reactions were: corneal verticillata, instillation site pain, and conjunctival hemorrhage. Instillation site erythema, corneal staining, blurred vision, increased lacrimation, erythema of eyelid, and reduced visual acuity were reported in 5-10% of patients.

The corneal verticillata seen in RHOPRESSA®-treated patients were first noted at 4 weeks of daily dosing. This reaction did not result in any apparent visual functional changes in patients. Most corneal verticillata resolved upon discontinuation of treatment.

INDICATION

RHOPRESSA® (netarsudil ophthalmic solution) 0.02% is a Rho kinase inhibitor indicated for the reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension.

Dosage and Administration: The recommended dosage is one drop in the affected eye(s) once daily in the evening.