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EUCRISA® (crisaborole) Eligibility Required Copay Savings Card 2

Save on EUCRISA*

Download your Copay Savings Card to start saving on prescriptions, for eligible patients.

Download your Copay Savings Card to start saving on prescriptions, for eligible patients.

First, let’s see if you may be eligible for the EUCRISA 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 do not have End Stage Renal Disease (ESRD).
  • 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, pharmaceutical assistance program, or prescription program).
  • I do not receive Social Security Disability (SSDI) or any other Social Security Administration (SSA) benefit.
  • Neither myself nor my family member are active duty military.

Good news! You’re eligible for the card.

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

Privacy Statement

Pfizer understands that your personal and health information is private. The information you provide will only be used by Pfizer and parties acting on its behalf to send you the materials you requested and other helpful information and updates on EUCRISA and/or eczema, as well as related treatments, products, offers, and services from eucrisa•4•you Savings and Support.

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*Terms and conditions apply.
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 .

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EUCRISA Copay Savings Card
TERMS AND CONDITIONS

EUCRISA® (crisaborole) ointment, 2%
Copay Savings Card

By using the EUCRISA Copay Savings Card, you acknowledge that you currently meet the eligibility criteria and will comply with the terms and conditions described below:

  • You are not eligible to use this card if you are enrolled in a state or federally funded prescription insurance program, including but not limited to Medicare, Medicaid, TRICARE, Veteran Affairs health care, a state prescription drug assistance program, or the Government Health Insurance Plan available in Puerto Rico (formerly known as "La Reforma de Salud").
  • You must have commercial insurance. Offer is not valid for cash-paying patients.
  • By using this copay card at participating pharmacies, eligible patients with commercial prescription drug insurance coverage for EUCRISA may pay as little as $10 per tube. Eligible patients with commercial prescription drug insurance coverage that does not cover EUCRISA may pay as little as $100 per tube. Individual savings are limited to $970 per tube. Individual patient savings are limited to $3,880 in maximum total savings per calendar year.
  • This copay card is not valid when the entire cost of your prescription drug is eligible to be reimbursed by your commercial insurance plan or any other health or pharmacy benefit program.
  • You must deduct the value of this copay card from any reimbursement request submitted to your commercial insurance plan, either directly by you or on your behalf.
  • You are responsible for reporting use of the copay card to any commercial insurer, health plan, or other third party that pays for or reimburses any part of the prescription filled using the copay card, as may be required. You should not use the copay card if your insurer or health plan prohibits use of manufacturer copay cards.
  • This copay card is not valid where prohibited by law.
  • Copay card cannot be combined with any other savings, free trial, or similar offer for the specified prescription.
  • Copay card will be accepted only at participating pharmacies.
  • This copay card is not health insurance.
  • Offer good only in the U.S. and Puerto Rico.
  • Copay card is limited to 1 per person during this offering period and is not transferable.
  • A copay card may not be redeemed more than once per 30 days per patient.
  • No other purchase is necessary.
  • Data related to your redemption of the copay card may be collected, analyzed, and shared with Pfizer, for market research and other purposes related to assessing Pfizer’s programs. Data shared with Pfizer will be aggregated and de-identified; it will be combined with data related to other copay card redemptions and will not identify you.
  • Pfizer reserves the right to rescind, revoke, or amend this offer at any time without notice.
  • Offer expires 03/31/2022.

For questions or additional support, call 1-877-548-1739, write to Pfizer Inc., at PO Box 29387, Mission, KS 66201.

Important Safety Information & Indication
 

IMPORTANT SAFETY INFORMATION

IMPORTANT SAFETY INFORMATION AND INDICATION

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.

INDICATIONEUCRISA 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 and Patient Information.

For more information call 1-866-EUCRISA (1-866-382-7472)

EUCRISA (crisaborole) ointment, 2%
MOBILE TEXT PROGRAM TERMS
  1. By opting into the EUCRISA mobile program, in which you can receive your Copay Savings Card via text, you consent to receive up to 10 text messages and/or push notifications per month from Pfizer Inc. Such messages may be marketing or non-marketing messages and may include, for example, refill reminders, fill confirmation, website information, etc. T-Mobile is NOT liable for delayed or undelivered messages.
  2. To stop receiving text messages, text STOP to 42762. DOING SO WILL ONLY OPT YOU OUT OF THE EUCRISA (CRISABOROLE) MOBILE PROGRAM; you will remain opted in to any other Pfizer Inc text message program(s) to which you separately opted in. You may unsubscribe from the digital wallet message Program at any time by disabling push notifications or removing the digital wallet pass from your device for digital wallet programs.
  3. To request more information or to obtain help, text HELP to 42762. You can also call customer service at 1-800-725-4125.
  4. You represent that you are the account holder for the mobile telephone number(s) that you provide to opt in to the texting program. You are responsible for notifying Pfizer Inc immediately if you change your mobile telephone number. You may notify Pfizer Inc of a number change by re-enrolling in the program.
  5. Message and data rates may apply to each text message sent or received in connection with the texting program, as provided in your mobile telephone service rate plan, in addition to any applicable roaming charges. Charges are both billed and payable to your mobile service provider or deducted from your prepaid account. Pfizer Inc does not impose a separate fee for sending text messages.
  6. Data obtained from you in connection with this Short Message Service (SMS) texting program may include your telephone number; your carrier’s name; the date, time and content of your messages; device information and elements of your pharmacy claim information. Pfizer Inc. may use this information to contact you and to provide the services you request from us.
  7. For information on data collection and use, please read our full corporate Privacy Policy, which is incorporated by reference into these Terms.
  8. In addition to the data use practices described in the Privacy Policy, we may send you Offer-related push notifications when your device is in the physical proximity of your pharmacy or healthcare provider. This is done through geofencing technology, which is built in to your device. Your device’s location will not be known or tracked by Pfizer or its service providers. Nonetheless, you may opt out of geofencing and receiving these notifications at any time by (1) disabling location services for your digital wallet app in your device’s settings, (2) disabling notifications (i.e., automatic updates) within the digital wallet app, or (3) removing the eCard from your digital wallet by selecting “Remove Pass” within the digital wallet app.
  9. Pfizer Inc will not be liable for any delays in the receipt of any SMS messages, as delivery is subject to effective transmission from your network operator.
  10. The service is available only on these US participating mobile carriers: Verizon Wireless, Sprint, Nextel, Boost Mobile, T-Mobile, AT&T, Alltel, ACS Wireless, Bluegrass Cellular, Carolina West Wireless, Cellcom, Cellular One of East Central Illinois (ECIT), Cincinnati Bell, Cricket Wireless, C Spire Wireless, Duet IP (AKA Max/Benton/Albany), Element Mobile, Epic Touch, GCI Communication, Golden State Cellular, Hawkeye (Chat Mobility), Hawkeye (NW Missouri Cellular), Illinois Valley Cellular (IVC), Inland Cellular, iWireless, Keystone Wireless (Immix/PC Management), MetroPCS, Mobi PCS, Mosaic Telecom, MTPCS/Cellular One (Cellone Nation), Nex-Tech Wireless, nTelos, Panhandle Telecommunications, Pioneer, Plateau, Revol Wireless, Rina-Custer, Rina-All West, Rina-Cambridge Telecom Coop, Rina-Eagle Valley Comm, Rina-Farmers Mutual Telephone Co, Rina-Nucla Nutria Telephone Co, Rina-Silver Star, Rina-South Central Comm, Rina-Syringa, Rina-UBET, Rina-Manti, Simmetry Wireless, South Canaan (Cellular One of NEPA), Thumb Cellular, Union Wireless, United Wireless, U.S. Cellular, Viaero Wireless, Virgin Mobile, West Central Wireless (includes Five Star Wireless).
  11. You agree to indemnify Pfizer Inc and parties texting on its behalf in full for all claims, expenses, and damages related to or caused in whole or in part by your failure to notify us if you change your telephone number, including but not limited to all claims, expenses, and damages related to or arising under the Telephone Consumer Protection Act.
  12. Pfizer Inc may suspend or terminate your receipt of text messages if it believes you are in breach of these SMS Terms and Conditions. Your receipt of text messages is also subject to termination in the event that your mobile telephone service terminates or lapses. Pfizer Inc reserves the right to modify or discontinue, temporarily or permanently, all or any part of the text messaging services you receive, with or without notice.
  13. Pfizer Inc may revise, modify, or amend these SMS Terms and Conditions at any time. Any such revision, modification, or amendment shall take effect when it is posted to Pfizer Inc’s website. You agree to review these SMS Terms and Conditions periodically to ensure that you are aware of any changes. Your continued consent to receive text messages will indicate your acceptance of those changes.

You are encouraged to report adverse events related to Pfizer products by calling 1-800-438-1985 (U.S. only). If you prefer, you may contact the U.S. Food and Drug Administration (FDA) directly.  Visit https://www.fda.gov/MedWatch or call 1-800-FDA-1088.

This site is intended only for U.S. residents. The products discussed in this site may have different product labeling in different countries.

The information provided is for educational purposes only and is not intended to replace discussions with a healthcare provider.

Copyright © 2020 Pfizer Inc.
All rights reserved.

Pfizer, PO Box 29387, Mission, KS 66201

Last Updated: December 2020
PP-CRI-USA-2705

Pfizer logo
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 .