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bSubject to a maximum copay assistance limit of $7000 per calendar year. Unless prohibited by law, Astellas may reduce the cost-sharing assistance available under the Program to a per claim maximum of $25 if it determines a claim for an enrolled patient is subject to a "maximizer" or "accumulator" program.

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PRINT your patient's copay program processing information. If you are the HCP, please send this information to your que es la vigilancia epidemiologica patient's specialty pharmacy. If you are the specialty pharmacy, please save this information to your patient's records and process the copay program claim accordingly

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