Personalized support for treatment with LISRAYA

The My Compass Support Copay Savings Program is available to eligible private insured patients only and is subject to the terms and conditions, including but not limited to the following:
• Not valid for patients whose prescriptions are reimbursed in whole or in part by any government-funded program (including Medicare, Medicaid, VA, TRICARE, or similar programs)
• Patient must be prescribed LISRAYA™ (brepocitinib) for an FDA-approved indication
• Patient must be a resident of the United States
• Patient must have commercial insurance coverage and an out-of-pocket cost for LISRAYA
Additional restrictions apply. My Compass Support reserves the right to modify or discontinue the program at any time without notice.
This program is not insurance and is not intended to substitute for insurance.
Patients: By enrolling in this copay savings program, you acknowledge and confirm that you and the prescription meet the eligibility requirements set forth in the terms and conditions, including that the prescription will not be reimbursed in whole or in part by any government-funded program (such as, without limitation, Medicare, Medicaid, VA, DOD, TRICARE). You may not submit any claims to government insurance plans for this prescription. You may not seek reimbursement from any health savings, flexible savings, or other healthcare reimbursement account for any amounts received from the copay program.
You are responsible for reporting the receipt of the copay program benefits if required by an insurer, payor, or applicable law or regulation.