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EUCRISA® (crisaborole) Eligibility Required Copay Savings Card 2

Activate your Copay
Savings Card here*

EUCRISA® (crisaborole) Eligibility Required Copay Savings Card 2

First, let’s see if you may be eligible for the Copay Savings Card.

All fields required unless otherwise noted.

Can you verify:

  • I am 18 years of age or older.
  • My partner and I are not over 65 years of age and retired.
  • I am a legal resident of the U.S. or Puerto Rico.

We also just need you to confirm:

  • I do not have insurance from any Federal Healthcare Program (including Medicare, Medicaid, Tricare, or any other state or federal medical pharmaceutical benefit program or pharmaceutical assistance program).
  • I do not receive Social Security Disability (SSDI) or any other Social Security Administration (SSA) benefit.
  • I do not receive health insurance through the military.

Good news! You’re eligible for the card.

*Eligibility required. No membership fees. For EUCRISA, individual savings limited to $970 per tube or $3,880 in maximum total savings per calendar year. For CIBINQO, the maximum benefit per patient is $15,000 per calendar year. Only for use with commercial insurance. If you are enrolled in a state or federally funded prescription insurance program, you may not use the copay card. Terms and conditions apply. For details on CIBINQO, please click full Prescribing Information, including BOXED WARNING, and Medication Guide or visit CIBINQO.com.

 

We’ll just need some information to get you started.

 

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Important Safety Information & Indication

IMPORTANT SAFETY INFORMATION

Do not use EUCRISA if you are allergic to crisaborole or any of the ingredients in EUCRISA.

EUCRISA may cause side effects including allergic reactions at or near the application site. These can be serious and may include hives, itching, swelling, and redness. If you have any of these symptoms, stop using EUCRISA and get medical help right away.

The most common side effect of EUCRISA is application site pain, such as burning or stinging.

EUCRISA is for use on skin (topical use) only. Do not use EUCRISA in your eyes, mouth, or vagina.

INDICATION
EUCRISA is a prescription ointment used on the skin (topical) to treat mild-to-moderate eczema (atopic dermatitis) in adults and children 3 months of age and older.

See Full Prescribing Information .