ABSORICA Co-Pay Card Program

Available to ABSORICA patients only

Uninsured? Click Here.

The ABSORICA Co-Pay Card Program offers ABSORICA patients a discount coupon card to help cover the cost of their treatment. Certain eligibility requirements and restrictions apply.

Summary of Program:

  • For commercially insured patients only*
  • Present discount coupon card to pharmacy
  • Call our Help Desk at 1-855-820-9189 for more processing information
  • Valid for five fills and subject to applicable program maximum restrictions
coupon

To obtain your ABSORICA Co-Pay Card and begin saving, please provide the following information. If you already have your card, activate it by entering your Card ID and completing the form below.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

ABSORICA Patient Assistance Program

Available for uninsured or underinsured patients who need assistance paying for their medication.

If you qualify, you may be able to receive your medication at no cost through the ABSORICA Patient Assistance Program (PAP).

To be eligible for the PAP, you must be a U.S. resident (including Puerto Rico) and must not have existing drug coverage for ABSORICA under any prescription drug benefit, including private insurance, Medicare, Medicaid, or other government insurance programs or be in the 90-Day Waiting Period for Medicare coverage. Your income must also be at or below 400% of the Federal Poverty Level (FPL) and you must be registered with the iPLEDGE Program by your prescriber.

See full eligibility requirements, or to speak to someone directly, call 833-SKIN-HLP (833-754-6457), Monday–Friday, 9AM-5:30PM EST.

To apply for our Patient Assistance Program:

  1. Complete the downloadable enrollment form in its entirety.
    Work with your prescriber to complete the form.
    Enrollment Form >
  2. Sign and date the form.
  3. Fax the completed, signed form, proof of income, and supporting documentation* explaining changes in circumstances to 866-810-3258.

More information on eligibility and enrollment is available here and by calling 833-SKIN-HLP (833-754-6457), Monday–Friday, 9AM-5:30PM EST.