The EUFLEXXA Commitment demonstrates our confidence in EUFLEXXA, the #1 prescribed HA. To prove it, we’re offering up to a $100 refund to eligible patients for your copay costs for EUFLEXXA if you’re not satisfied with your OA knee pain relief 10 weeks after your last injection. To qualify for the refund, you must have received all 3 EUFLEXXA injections as indicated i.e. 1 injection a week for 3 weeks, between 4/1/2019-12/31/2019 and meet all the terms and conditions of the program. A complete refund form, Explanation of Benefits (EOB) from your insurance company and proof of payment must be received no later than 14 weeks after your last injection. See Offer Terms and Conditions below for further details. ††

TO RECEIVE YOUR REFUND:
1) Print, complete, and submit refund form
2) Attach Explanation of Benefits for each injection from your insurance company or payment receipt for Euflexxa (for cash-paying patients)
3) Attach receipt(s) reflecting payment towards your copay amount for EUFLEXXA
4) Fax to: The EUFLEXXA Commitment at 866-383-5392


††Offer Terms and Conditions:

  • This offer is not valid for any other Ferring Pharmaceuticals Inc product. Fax-in only. No mail, phone, or emailed requests will be honored
  • Ferring Pharmaceuticals is not responsible for lost, late, damaged, misdirected, incomplete or illegible submissions
  • The value of this refund may not exceed the amount of patient’s responsibility (copay) for the prescription. Maximum refund amount is $100.
  • Offer limited to cash-paying or commercial US residents who received three (3) injections of EUFLEXXA within 21 days as indicated i.e one injection a week for 3 weeks and are undergoing their first EUFLEXXA treatment regimen.
  • Refund claims must be received between 10 and 14 weeks after the last injection. All claims must be received by January 31, 2020
  • Limit one refund per eligible patient
  • Ferring Pharmaceuticals reserves the right to cancel, modify, or rescind the program at any time
  • The patient responsibility (copay) for the injection administration and/or EUFLEXXA must be isolated on the claim. Office visits or other ancillary costs included in patient’s responsibility are excluded from refund amount
  • This offer is void where prohibited or restricted by law. Offer not valid for prescriptions and/or services reimbursed in whole or in part by any federal or state healthcare program, including without limitation Medicare, Medicaid, Department of Veterans Affairs healthcare program, TRICARE and any federal or state employee benefit program
  • Please retain copies of the materials you submit. All submissions become the property of a Ferring Pharmaceuticals contracted third-party vendor
  • Patient must fully complete and follow instructions as stated on the claim form
  • Tampering with, altering, or falsifying payment information constitutes fraud
  • Please allow 4-6 weeks for delivery of refund check. Refund check will be issued in US dollars

Please See Important Safety Information and Full Prescribing Information.

INDICATION

EUFLEXXA (1% sodium hyaluronate) is used to relieve knee pain due to osteoarthritis. It is used for patients who do not get enough relief from simple pain medications such as acetaminophen or from exercise and physical therapy.

EUFLEXXA is only for injection into the knee, performed by a doctor or other qualified healthcare professional.

IMPORTANT SAFETY INFORMATION

  • Do not take this product if you have had any previous allergic reaction to EUFLEXXA or hyaluronan products.
  • You should not have EUFLEXXA injected into the knee if you have a knee joint infection or skin diseases or infections around the injection site.
  • EUFLEXXA has not been tested in pregnant women, women who are nursing or in children less than 18 years of age. After you receive your EUFLEXXA injection you should avoid physical activities for 48 hours such as jogging, tennis, heavy lifting, or standing on your feet for a long time (more than one hour at a time).
  • The most common adverse events related to EUFLEXXA injections were joint pain, back pain, limb pain, muscle pain, and joint swelling.

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.
You may also contact Ferring Pharmaceuticals Inc. at 1-888-FERRING.