QULIPTA Financial Assistance Guide

This category includes insurance plans provided through an employer, purchased with subsidy support from the Affordable Care Act (Obamacare) or purchased privately.

98% of commercially insured lives nationwide are now covered for QULIPTA.

62% of nationally commercially insured lives are now covered for QULIPTA with zero steps.

Highlights of QULIPTA Copay Card:

Sign up for QULIPTA Complete to start saving and get support.

How to Sign Up:

• Visit QULIPTA.com/savings
• Text* 785478 to enroll
• Call 1-855-QULIPTA (1-855-785-4782)

97% of patients who use a QULIPTA Complete Savings Card pay $0. Available to patients with commercial insurance coverage for QULIPTA who meet eligibility criteria. This copay assistance program is not available to patients receiving prescription reimbursement under any federal, state, or government-funded insurance programs (for example, Medicare [including Part D], Medicare Advantage, Medigap, Medicaid, TRICARE, Department of Defense, or Veterans Affairs programs), or where prohibited by law. Offer subject to change or termination without notice. Restrictions, including monthly maximums, may apply. This is not health insurance. For full Terms and Conditions, visit QULIPTASavingsCard.com or call 1-855-QULIPTA (1-855-785-4782) for more information. To learn about AbbVie’s privacy practices and your privacy choices, visit https://privacy.abbvie/privacy-policies/us-privacy-policy.html.

QULIPTA is now covered for about 3 out of 4 Medicare Part D lives.

Reasons why your monthly cost may differ:

• A lack of supplemental coverage (Part D)
• The benefit varies during different coverage phases of most Part D plans
• Not all Part D plans are the same and they may have different rules and benefits

Eligible commercially insured patients may pay as little as $0 for their prescription with the QULIPTA® Complete Savings Card.

Reasons why your monthly cost may differ:

• Household income could play a role in determining your monthly cost
• Out-of-pocket charges vary from state to state

The Wholesale Acquisition Cost (WAC), also known as the list price, for a 30-day supply of QULIPTA is $1,147.21 as of January 2025. The WAC may not reflect the price paid by patients.