About OMNARIS (ciclesonide) Nasal Spray
Enroll in the Relief Is Here Co-pay Program, and you’ll pay only $17 every time you fill your OMNARIS (ciclesonide) prescription — up to 12 times per year.* That's like getting OMNARIS prescription medicine for your nasal allergy symptom relief for the price of a generic!
Money Saving Offer
Do you suffer from symptoms of allergic rhinitis, such as sneezing, itchy nose, runny nose, and/or congestion? Qualified patients may be eligible for a reduction in their Rx co-pay for OMNARIS® (ciclesonide) Nasal Spray.
Sign up to save up to $50 on each of your next 12 prescriptions or refills of OMNARIS nasal allergy spray. That’s a savings of up to $600 for the year!*
Pay as low as $17* on EVERY Rx and refill.
To enroll on-line and receive a Relief is Here Co-pay Program e-card, click on "SIGN UP NOW". Please note a valid e-mail address is required to create or activate your Relief Is Here co-pay card online. If you are unwilling or unable to provide this information, you can also enroll or activate your card by calling (866) 278-9738.
If you already have a card and need to activate it, click on “ACTIVATE CARD." If you lost your card or need to reprint your e-card, click on “REPRINT CARD,” and you will be asked to enter the email address you used for registration. If you did not register with an email, please call 866-278-9738 to request a replacement card.
* Most insured patients will pay no more than $17 monthly with a maximum benefit of $50 per fill. Restrictions apply and co-pay amounts may vary.See program rules and eligibility.
Program Rules: Patient Eligibility, Terms, and Conditions
Valid only for qualified customers with a valid prescription for ZETONNA™ (ciclesonide) Nasal Aerosol or OMNARIS® (ciclesonide) Nasal Spray. No substitutions permitted.
A parent or guardian must enroll in the Relief Is Here Co-pay Program on behalf of a patient under 18 years of age
Not valid for prescriptions covered or paid for by Medicare (including true out-of-pocket expenses under Medicare Part D), Medicaid, or any other federal or state healthcare programs, such as state pharmaceutical assistance programs.
Your discount with the Relief Is Here Co-payProgram card is valid to reduce your co-pay to $17 with a maximum reduction of $50 per prescription. Discount available on up to twelve (12) prescription fills for ZETONNA Nasal Aerosol or OMNARIS Nasal Spray per calendar year.
Your acceptance of this offer must be consistent with the terms of any drug benefit provided by a health insurer, health plan, or other third-party payor, and you agree to report acceptance of this offer to your health insurer, health plan, or third-party payor as may be required.
Offer limited to one card per person, and may not be used with any other discount, coupon, or offer.
Only an original Relief Is Here Co-pay Program card or Web-generated paper card will be accepted and must be presented to your pharmacist at the time you have the prescription filled—not valid if reproduced.
Offer valid only in the United States. Void where prohibited by law, taxed, or restricted.
Sunovion Pharmaceuticals Inc. reserves the right to change or discontinue this offer at any time without notice.
By participating in this program, you, the patient, certify that (a) you have read the above terms; (b) you are not reimbursed, nor will you submit a claim for reimbursement, nor will you seek to have any portion of this prescription counted toward your out-of-pocket costs (eg, TrOOP) under any federal, state, or private programs for this or other prescriptions for ZETONNA Nasal Aerosol or OMNARIS Nasal Spray to which this offer will apply; and (c) you will comply with the terms above.
Using mail-order pharmacies
Check with your mail-order pharmacy to see if they accept co-pay cards such as the Relief Is Here Co-pay Program card (most of them do). If they do, all you need to do is submit a photocopy of your card or Web-generated paper card along with your prescription and insurance card information.
For mail-order pharmacies that do not accept co-pay cards, we will reimburse you for the difference so that you are still getting OMNARIS for $17. Visit www.patientrebateonline.com for more information.