Patient Instructions: To redeem the MARPLAN Co-pay Card, you must have a valid prescription for Marplan® (isocarboxazid) Tablets. Follow the dosage instructions given by the doctor. You will be required to pay the first $20 of your co-pay, after which an amount of up to $100 for a 30-day supply, $150 for a 60-day supply, or $200 for a 90-day supply will be deducted from your remaining balance. The pharmacist will process your insurance information and this MARPLAN Co-pay Card and then inform you of your co-pay amount. 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 indicated below. If you have any questions about the use of your MARPLAN Co-pay Card, please call 1-866-297-6945.
Pharmacist instructions for a Patient paying with an Eligible Third Party: Submit the claim to the primary Third-Party Payer first, then submit the balance due to Change Healthcare as a Secondary Payer COB [coordination of benefits] with patient responsibility amount and a valid Other Coverage Code, (eg, 8). Patients are responsible for the first $20, after which an amount of up to $100 for a 30-day supply, $150 for a 60-day supply, or $200 for a 90-day supply of MARPLAN will be deducted from their remaining balance. Reimbursement will be received from Change Healthcare.
Pharmacist instructions for a Cash-Paying Patient: Submit this claim to Change Healthcare. A valid Other Coverage Code (eg, 1) is required. Patients are responsible for the first $20, after which an amount of up to $100 for a 30-day supply, $150 for a 60-day supply, or $200 for a 90-day supply of MARPLAN will be deducted from their remaining balance. Reimbursement will be received from Change Healthcare.
Valid Other Coverage Code required. For any questions regarding Change Healthcare online processing, please call the Help Desk at 1-800-422-5604.
Restrictions: This promotion cannot be combined with any other programs, offers, or discounts. A prescription for MARPLAN must be filled in order to use this card. THIS OFFER IS NOT VALID FOR PRESCRIPTIONS THAT ARE ELIGIBLE TO BE REIMBURSED, IN WHOLE OR IN PART, BY MEDICAID, MEDICARE (INCLUDING MEDICARE PART D), OR OTHER FEDERAL OR STATE HEALTHCARE PROGRAMS. Patients are responsible for reporting receipt of any program rewards to any private insurer or health or pharmacy benefit programs that reimburse the entire cost of the prescription. Void where prohibited by law or restricted. Void outside the U.S. This card is the property of Validus Pharmaceuticals LLC and must be returned upon request.
This offer is not transferable. Not valid if reproduced. Void where prohibited by law. Program managed by ConnectiveRx on behalf of Validus Pharmaceuticals LLC. The parties reserve the right to rescind, revoke, or amend this offer without notice at any time.
Because of its potentially serious side effects, MARPLAN should not be considered as the first choice for the treatment of depression, but should be considered when other antidepressants have failed to control symptoms of depression. You should talk to your healthcare provider about the benefits and risks associated with treatment.
What is the most important information I should know about MARPLAN?
Foods you CANNOT eat:
In general, you should avoid foods that are aged to increase flavor.
|Meat, Poultry and Fish
|Dairy (milk products)
|Fruits and Vegetables
Who should not take MARPLAN?
Do not take MARPLAN if you
What should I tell my healthcare provider before taking MARPLAN?
Some medications can interact with MARPLAN and cause serious unwanted effects. To avoid these effects, be sure to tell your doctor about ALL of the other medications you are taking, including herbal supplements.
Before you take MARPLAN, tell your healthcare provider if you have any of the following conditions:
The most common side effects of MARPLAN include
These are not all the possible side effects of MARPLAN. For more information, ask your healthcare provider or pharmacist. Tell your healthcare provider if you have any side effects that bothers you or that does not go away.
Please refer to the full Prescribing Information for a list of inactive ingredients found at www.marplan.com.
What should I avoid while taking MARPLAN?
See the Contraindications section of the full Prescribing Information for a complete list of drugs to avoid.
The risk information provided here is not comprehensive. To learn more, talk about MARPLAN with your doctor or pharmacist. The FDA-approved product labeling can be found at www.marplan.com or 1-866-982-5438.
MARPLAN is available by prescription only.
Please see the accompanying Medication Guide at www.marplan.com.