Comprehensive support, including First Month Free To Eligible Patients For Danziten^TM (nilotinib)

First Free Month Offer Terms and Conditions

• The patient must have a valid prescription for Danziten^TM (nilotinib).
• The patient must be 18 years of age or older to be eligible for this program.
• This offer is good for all eligible patients who are residents of the United States or Puerto Rico. Void where prohibited by law.
• Offer is limited to one per patient per lifetime and is not transferable. Not valid if reproduced.
• This first free month offer is not health insurance.
• No claim for reimbursement for product dispensed pursuant to this offer may be submitted to any third-party payer, whether a commercial, private or a government payer.
• This offer cannot be combined with any other rebate/offer, free trial or similar for the specified prescription.
• Valid only for patients new to Danziten^TM (nilotinib) and for their first month of medication. Existing and restart patients to Danziten^TM (nilotinib) are not eligible.

Patient Instructions: This first free month offer is valid for up to a 30 days’ supply of DanzitenTM (nilotinib). Offer must be presented to your pharmacist along with a valid prescription. Offer is valid for your first prescription of DanzitenTM (nilotinib) and one per patient per lifetime. Please call 1-800-657-7613 with any questions. Azurity and its service providers reserve the right to rescind, recall, revoke or amend this without notice at any time.

Pharmacist Instructions: The first free month offer must accompany a valid prescription. Patient must be naïve to DanzitenTM (nilotinib). One offer per patient per lifetime and for patient’s first month of medication. No substitution allowed. Please dispense at no cost to the patient. For reimbursement, please submit this electronically as a primary claim to BIN# 610524, RxPCN 1016, and RxGroup# 40028208. Do not submit to any other payer. For questions, please call the Help Desk at 1-800-657-7613. Azurity and its service providers reserve the right to rescind, recall, revoke or amend this without notice at any time.

Danziten CONNECT^SM Co-pay Program Terms and Conditions:

• The patient must have a valid prescription for Danziten^TM (nilotinib).
• The patient must be 18 years of age or older to be eligible for this program.
• The program is not valid for prescriptions that are eligible for reimbursement, in whole or in part by Medicaid, Medicare, or other federal or state healthcare programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico [formerly known as “La Reforma De Salud”]).
• This program is not valid for prescriptions that are eligible for reimbursement by private insurance plans or other health or pharmacy benefit programs that reimburse you for the entire cost of your prescription drugs.
• Each patient is limited to one active Co-pay offer at a time during this offer period and the Co-pay assistance offer is not transferable.
• The program cannot be combined with any other rebate, coupon, free trial, or similar offer for the specified prescription.
• The Co-pay Program is not health insurance.
• This offer is good only in the United States and Puerto Rico as allowed by law.
• Offer valid until the end of the current calendar year.
• Azurity reserves the right to rescind, revoke, or amend co-pay assistance without notice.
• For questions regarding the Co-pay assistance, please call the Help Desk at 1-888-215-8350.