Orenitram 90-Day Trial Program Terms & Conditions

The Orenitram 90-Day Trial Program (“Trial Program”) is offered by United Therapeutics Corporation. To utilize this Trial Program, you must have a valid prescription for an FDA-approved use of Orenitram. There is no obligation to continue Orenitram after the 90-Day Trial Program. If the decision is made to continue therapy, a separate prescription must be written by your healthcare provider and dispensed by one of United Therapeutics Corporation’s contracted Specialty Pharmacies, Accredo or CVS Specialty. Patients may be offered the Trial Program exclusively through their healthcare provider.

Terms & conditions for trial program

By enrolling in the 90-Day Trial Program for Orenitram, you acknowledge that you currently meet the eligibility criteria and will comply with the Terms & Conditions described below:

1. Only new patients with a valid prescription for an FDA-approved use of Orenitram may use this Trial Program. This Trial Program is not valid for patients transitioning to Orenitram from Tyvaso or Remodulin. By enrolling in this Trial Program, you certify that: (a) you are not currently using and have not previously used Orenitram outside of the hospital setting (i.e., “Outpatient”), and (b) you are not currently taking an inhaled or infused prostacyclin.
2. Patients are not eligible to start the Trial Program in the hospital setting (i.e., “Inpatient”).
3. Product cannot be shipped to a hospital, physician’s office, etc. Product must be shipped directly to the patient.
4. This offer is only valid for those patients 18 years and older.
5. Only 1 enrollment per patient may be redeemed under this program; no photocopies or reproductions of the enrollment form will be accepted.
6. Enrollment is valid for 90 days of Orenitram at no cost to the patient.
7. No claim for reimbursement for product dispensed pursuant to this Trial Program may be submitted, in whole or part, to any third-party payer, including a public or private payer.
8. The prescription for the Trial Program cannot be submitted to count toward out-of-pocket costs under any prescription medicine plan.
9. For Medicare patients, Trial Program product may not count toward “True Out-of-Pocket (TrOOP)” expenses.
10. The Trial Program enrollment form will be accepted only at United Therapeutics Corporation’s contracted pharmacy for this Program, Lash and Group. Offer not valid if submitted to any other pharmacy.
11. This enrollment form is not transferable. It is illegal for any person to sell, purchase, or trade, or offer to sell, purchase, or trade or to counterfeit this voucher.
12. This 90-Day Trial Program cannot be combined with any other rebate/coupon, free trial, or similar offer for the specified prescription.
13. This free trial is not health insurance.
14. United Therapeutics Corporation makes no express or implied guarantee that Orenitram will be covered by any third-party payer after the 90-day trial period.
15. Offer good only in the United States and Puerto Rico.
16. United Therapeutics Corporation reserves the right to rescind, revoke, or amend this free trial program at any time without notice.