By accessing and printing a voucher or coupon for a product from this application for an eligible patient, you acknowledge that you are authorized to prescribe the product for its intended use. Please note that Merck does not recommend the use of any product in a manner inconsistent with the Prescribing Information.
NOTICE OF RESTRICTION FOR VERMONT HEALTH CARE PROFESSIONALS:
Due to requirements that Vermont imposes on pharmaceutical manufacturers' interactions with health care professionals, health care professionals that are authorized to prescribe and licensed to provide health care in Vermont should not access or print vouchers or coupons from this application. Vermont health care professionals may contact the Merck National Service Center at 800-672-6372 to request available vouchers or coupons for their appropriate patients.
I acknowledge the above notices. I am not a Vermont health care professional.
The coupon is valid for up to $20 off on 1 qualifying prescription for AzaSite (regardless of the quantity supplied on the prescription).
Coupon is valid for 1-time use only. Patient must have a copayment or make full cash payment for the prescription. Savings are limited to amount of your out-of-pocket cost, up to a maximum of $20.
No other purchase is necessary.
The coupon is not transferable. No substitutions are permitted. Cannot be combined with any other coupon, free trial, discount, prescription savings card, or other offer.
The coupon is not insurance.
The coupon is valid for patients with private insurance or cash-paying patients. Not valid for patients covered under Medicaid, Medicare, a Medicare Part D or Medicare Advantage plan (regardless of whether a specific prescription is covered), TRICARE, CHAMPUS, Puerto Rico Government Health Insurance Plan ("Healthcare Reform"), any qualified health plan purchased through a health insurance exchange established by a state government or the federal government, or any other state or federal medical or pharmaceutical benefit program or pharmaceutical assistance program (collectively, "Government Programs").
You must be 18 years of age or older to redeem the coupon. Patient, pharmacist, and prescriber agree not to seek reimbursement for all or any part of the benefit received by the patient through the offer. Patient is responsible for reporting receipt of coupon benefit to any insurer, health plan, or other third party who pays for or reimburses any part of the prescription filled using the coupon, as may be required.
The coupon can be used only by eligible United States or Commonwealth of Puerto Rico residents at participating eligible retail or mail-order pharmacies in the United States or the Commonwealth of Puerto Rico. Product must originate in the United States or the Commonwealth of Puerto Rico.
The coupon is the property of Merck and must be turned in on request.
It is illegal to sell, purchase, trade, or counterfeit, or offer to sell, purchase, trade, or counterfeit the coupon. Void if reproduced. Void where prohibited by law, taxed, or restricted.
Merck reserves the right to rescind, revoke, or amend this offer at any time without notice.
Data related to your redemption of the coupon may be collected, analyzed, and shared with Merck, for market research and other purposes related to assessing coupon programs. Data shared with Merck will be aggregated and de-identified, meaning it will be combined with data related to other coupon redemptions and will not identify you.