Botox OnabotulinumtoxinA Injection BOTOX® for adults with Chronic Migraine with 15 or more headaches per a month.
Chronic Migraine
Allergan

The BOTOX® Savings Card

Most insurance plans cover the cost of BOTOX® treatment

For any remaining out-of-pocket costs, there's the BOTOX® Savings Card. With the help of the savings card, most people with commercial insurance pay nothing out-of-pocket for treatment.*

SPECIAL OFFER FOR NEW BOTOX® PATIENTS

For a limited time, people with Chronic Migraine may get their first 2 BOTOX® treatments in 2017 with no out-of-pocket costs.

BOTOX<sup>®</sup> Savings Card BOTOX<sup>®</sup> Savings Card
First treatment

No

out-of-pocket

costs

(Up to $500)

Second treatment

No

out-of-pocket

costs

(Up to $500)

Additional treatments

Continued savings

on out-of-pocket costs

(up to 4 treatments; based on your progress, your doctor will determine re-treatment)

Start saving on treatment

If you meet the following criteria, you may be eligible:

  • Have commercial insurance (cannot be enrolled in or eligible for Medicare, Medicaid, or any other federal or state government healthcare program)
  • Scheduled your first treatment from January–December 2017
  • Never received BOTOX® treatment for Chronic Migraine

Please see below for offer details.

Already received BOTOX® treatment? You can still save!

Up to $400

savings on out-of-pocket costs for 1 treatment†‡

January to March

Up to $200

savings on out-of-pocket costs per treatment (up to 4 treatments)†‡

April to December

Your total savings per calendar year can add up to $1200.

Treatment must be at least 12 weeks apart.

5 steps to savings

Follow these steps to take advantage of the savings offers above.

  • Step 1

    Receive BOTOX® treatment. To take advantage of this new patient offer, your first treatment must be scheduled between January–December 2017.

  • Step 2

    Your insurance company will send you an Explanation of Benefits (EOB) showing how much you owe for your BOTOX® treatment. If you ordered BOTOX® through a Specialty Pharmacy Provider (SPP), you will also receive a receipt from them.

  • Step 3

    Visit BOTOXSavingsCard.com and enroll.

  • Step 4

    You will receive a Welcome Letter in the mail. Follow the instructions to submit a claim on the BOTOX  ® Savings Card site (as part of the claim, you will have to submit an EOB and/or an SPP receipt).

  • Step 5

    If your claim is approved, you will receive a BOTOX® Savings Card with the amount you paid for BOTOX® treatment, which you can use to cover your next treatment.§

Savings that continue over time

To continue to save, follow the steps above for your next BOTOX® treatment—and for every treatment after. Each time your claim is approved, the funds on your BOTOX® Savings Card will be refilled.

Stay on track

Get healthy living tips from Prevention® Magazine, along with treatment reminders to stay on track with BOTOX® treatment.

Sign up here

*82% of people with commercial insurance pay nothing with the BOTOX® Savings Card. Data on file, collected Jan 2014–Dec 2014: n=29388. Coverage and out-of-pocket costs vary. Must meet eligibility criteria to qualify. The program is available for patients receiving treatment every 12 weeks. Patients should understand their out-of-pocket costs before starting treatment.

Covers out-of-pocket costs of BOTOX® and related procedures for up to 5 treatments in a 12-month period. Treatment must be at least 12 weeks apart.

Coverage and out-of-pocket costs may vary. Offer not valid for patients enrolled in Medicare, Medicaid, or other federal or state healthcare programs. See below for full Terms and Conditions.

§In order to get reimbursed the full amount for your second treatment, it must be between 84 days (12 weeks) and 90 days after your first treatment.

IMPORTANT SAFETY INFORMATION (continued)Back to top

Important Safety Information & Approved UseExpandCollapse

Indication
BOTOX® is a prescription medicine that is injected to prevent headaches in adults with chronic migraine who have 15 or more days each month with headache lasting 4 or more hours each day in people 18 years or older.

It is not known whether BOTOX® is safe or effective to prevent headaches in patients with migraine who have 14 or fewer headache days each month (episodic migraine).

IMPORTANT SAFETY INFORMATION
BOTOX® may cause serious side effects that can be life threatening. Get medical help right away if you have any of these problems any time (hours to weeks) after injection of BOTOX®:

  • Problems swallowing, speaking, or breathing, due to weakening of associated muscles, can be severe and result in loss of life. You are at the highest risk if these problems are pre-existing before injection. Swallowing problems may last for several months.
  • Spread of toxin effects. The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice, trouble saying words clearly, loss of bladder control, trouble breathing, trouble swallowing.

There has not been a confirmed serious case of spread of toxin effect away from the injection site when BOTOX® has been used at the recommended dose to treat chronic migraine.

BOTOX® may cause loss of strength or general muscle weakness, vision problems, or dizziness within hours to weeks of taking BOTOX®. If this happens, do not drive a car, operate machinery, or do other dangerous activities.

Do not take BOTOX® if you: are allergic to any of the ingredients in BOTOX® (see Medication Guide for ingredients); had an allergic reaction to any other botulinum toxin product such as Myobloc® (rimabotulinumtoxinB), Dysport® (abobotulinumtoxinA), or Xeomin® (incobotulinumtoxinA); have a skin infection at the planned injection site.

The dose of BOTOX® is not the same as, or comparable to, another botulinum toxin product.

Serious and/or immediate allergic reactions have been reported. They include itching, rash, red itchy welts, wheezing, asthma symptoms, or dizziness or feeling faint. Get medical help right away if you experience symptoms; further injection of BOTOX® should be discontinued.

Tell your doctor about all your muscle or nerve conditions such as ALS or Lou Gehrig's disease, myasthenia gravis, or Lambert-Eaton syndrome, as you may be at increased risk of serious side effects including difficulty swallowing and difficulty breathing from typical doses of BOTOX®.

Tell your doctor about all your medical conditions, including if you: have or have had bleeding problems; have plans to have surgery; had surgery on your face; weakness of forehead muscles; trouble raising your eyebrows; drooping eyelids; any other abnormal facial change; are pregnant or plan to become pregnant (it is not known if BOTOX® can harm your unborn baby); are breastfeeding or plan to (it is not known if BOTOX® passes into breast milk).

Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal products. Using BOTOX® with certain other medicines may cause serious side effects. Do not start any new medicines until you have told your doctor that you have received BOTOX® in the past.

Tell your doctor if you have received any other botulinum toxin product in the last 4 months; have received injections of botulinum toxin such as Myobloc®, Dysport®, or Xeomin® in the past (tell your doctor exactly which product you received); have recently received an antibiotic by injection; take muscle relaxants; take an allergy or cold medicine; take a sleep medicine; take aspirin-like products or blood thinners.

Other side effects of BOTOX® include: dry mouth, discomfort or pain at the injection site, tiredness, headache, neck pain, and eye problems: double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of your eyelids, and dry eyes.

For more information refer to the Medication Guide or talk with your doctor.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Indication
BOTOX® is a prescription medicine that is injected to prevent headaches in adults with chronic migraine who have 15 or more days each month with headache lasting 4 or more hours each day in people 18 years or older.

It is not known whether BOTOX® is safe or effective to prevent headaches in patients with migraine who have 14 or fewer headache days each month (episodic migraine).

Please see BOTOX® full Product Information including Boxed Warning and Medication Guide.

References:

  1. Natoli JL, Manack A, Dean B, Butler Q, Turkel CC, Stovner L & Lipton RB. Global prevalence of chronic migraine: a systematic review. Cephalalgia 2009.
  2. Data on file, IMS Pharmetrics + Claims Database.

Card Usage Language
Your BOTOX® Savings Card may only be used at hospitals, physician offices, and pharmacies, and will not be accepted at any other location that normally accepts Visa® Debit cards. The BOTOX® Savings Card cannot be used at merchants outside the United States (including Internet and mail/telephone merchants).

This card is issued by Metropolitan Commercial Bank (Member FDIC) pursuant to a license from Visa U.S.A. Inc. "Metropolitan Commercial Bank" and "Metropolitan" are registered trademarks of Metropolitan Commercial Bank ©2014.

TERMS AND CONDITIONS
By participating, the user understands and agrees to comply with the Program rules as set forth below.

The BOTOX® Savings Card provides savings on out-of-pocket costs for BOTOX® (onabotulinumtoxinA) and related procedures. New patients can receive up to $500 off 1 treatment received January-December 2017 and up to $500 off 1 treatment between 84 days (12 weeks) and 90 days after the first treatment. Existing patients can receive up to $400 off 1 treatment received January-March 2017 and up to $200 off per treatment for up to 4 treatments received April-December 2017. All treatments must be received within a 12-month period.

Offer is valid only for BOTOX® and BOTOX® treatment-related costs not covered by insurance. The BOTOX® Savings Card will be funded upon approval of a claim. The claim must be submitted with an Explanation of Benefits (EOB) or a Specialty Pharmacy Provider (SPP) receipt. (If the BOTOX® prescription was filled by a Specialty Pharmacy Provider, both an EOB and SPP receipt must be sent.)

All claims must be submitted within 90 days of the date of service listed on the EOB. BOTOX® Savings Card may not be combined with any other offer or discount. This BOTOX® Savings Card is not health insurance.

Offer not valid for patients participating in Medicare, Medicaid, or any similar federal or state healthcare program, including any state medical or pharmaceutical assistance programs. If patients are eligible for drug benefits under any such program, they cannot use this BOTOX® Savings Card.

Offer void where prohibited by law, taxed, or restricted. Offer good only in the United States. Allergan reserves the right to rescind, revoke, and amend this offer without notice.