As part of our commitment to patients, Merz created the XEOMIN Patient Savings Program
As of January 1, 2019, the Xeomin® Patient Savings Program has been enhanced so that eligible patients with commercial insurance can save up to $5,000 over a rolling 12-month period and pay as low as $0 out of pocket. Actual co-pay and out-of-pocket expense may vary depending upon the patient's specific commercial insurance plan and state requirements.
To be eligible, you must:
Be a clinically appropriate patient for therapeutic treatment with XEOMIN, as determined by your doctor
Be prescribed XEOMIN
Be at least 18 years of age and less than 65 years of age.
Have commercial insurance that covers XEOMIN medication costs
Not be enrolled in a state or federally funded prescription insurance program. This includes patients enrolled in Medicare, Medicare Advantage, Medicare Part D, Part B, Medicaid, Medigap, TRICARE, Veterans Affairs (VA), the Department of Defense (DOD) or other federally funded or state funded health care programs, as well as patients who are Medicare eligible and enrolled in an employer-sponsored group waiver health plan or government subsidized prescription drug benefit program for retirees. If a patient is enrolled in a state or federally funded prescription insurance program, they are not eligible, even if they elect to be processed as an uninsured (cash-paying) patient
Merz North America, Inc. reserves the right to modify or discontinue any and all aspects of the program at any time and without notice.
Further restrictions apply to eligibility and reimbursable expenses. Please see full terms and conditions below or call 1-888-4-XEOMIN (1-888-493-6646).
To obtain a XEOMIN Patient Savings Program application, you can:
Call 1-888-4-XEOMIN (1-888-493-6646) between 8 am and 8 pm ET
For additional information, please download the XEOMIN Patient Savings Program brochure, available here
Eligibility, Terms and Conditions, and Program Limitations
The program covers eligible patients’ actual out-of-pocket XEOMIN medication costs and related administration fees up to a maximum amount of $5000 per 12-month period beginning with patient’s acceptance into the Program. The Program does not cover (a) office visit co-pays not directly associated with XEOMIN treatment; (b) facility co-pays not directly associated with XEOMIN treatment; or (c) any other costs excluded by the Program guidelines not specifically mentioned herein, which are subject to change.
Eligible patients must be clinically appropriate patients for therapeutic treatment with XEOMIN. Patient must be prescribed XEOMIN. Eligible patients must be at least 18 years of age and less than 65 years of age.
This offer is valid only in the United States, excluding where it is otherwise prohibited by law. Patients residing in the states of Massachusetts, Michigan, Rhode Island, and Minnesota are eligible for drug co-payment assistance only and are not eligible for other types of co-payment assistance, including but not limited to costs related to administration of the drug.
Eligible patients must have private commercial insurance that covers medication costs for XEOMIN, and acceptance of this offer must be consistent with the terms of that insurer’s drug benefit. Eligible patients must not have coverage for XEOMIN through Medicare, Medicare Advantage, Medicare Part D, Medicaid, Medigap, TRICARE, Veterans Affairs (VA), the Department of Defense (DoD), or other federally funded or state funded healthcare programs. Patients who move from commercial to federally funded or state funded insurance will no longer be eligible for the Program. Proof required for receiving payment for out of pocket drug costs must be a valid explanation of benefits (EOB) or specialty pharmacy invoice, which must be submitted within 120 days after each treatment.
Patient may not seek reimbursement for value received from the Program from any third-party payers, including flexible spending accounts or healthcare savings accounts. If at any time patient begins receiving coverage under any federal, state or government funded healthcare program, Patient is no longer eligible to participate in the Program and must call 1-888-4XEOMIN (1-888-493-6646) between 8 AM and 8 PM (EST) to stop participation. Restrictions may apply. This is not health insurance.
Patient and patient’s pharmacist are responsible for notifying insurance carriers or any other third party who pays for or reimburses any part of the prescription filled using the Program as may be required by the insurance carrier’s terms and conditions and applicable law.
Enrollment in the Program may be reviewed on an annual basis to determine continued eligibility. This offer may not be combined with any other coupon, discount, prescription savings card, free trial, or other offer for XEOMIN.
This is a limited time offer, and Merz reserves the right to rescind, revoke, amend, or terminate this offer, or the Program in its entirety, at any time, without notice.
XEOMIN® (incobotulinumtoxinA) IMPORTANT CONSUMER SAFETY INFORMATION
Read the Medication Guide before you start receiving XEOMIN® (Zeo-min) and each time XEOMIN is given to you as there may be new information. The risk information provided here is not comprehensive. To learn more:
that is injected into glands that make saliva and is used to treat long-lasting (chronic) drooling (sialorrhea).
that is injected into muscles and used to:
treat increased muscle stiffness in the arm because of upper limb spasticity.
treat the abnormal head position and neck pain with cervical dystonia (CD) in adults.
treat abnormal spasm of the eyelids (blepharospasm) in adults who have had prior treatment with onabotulinumtoxinA (BOTOX®).
It is not known if XEOMIN is safe and effective in children under 18 years of age.
XEOMIN may cause serious side effects that can be life threatening. Call your doctor or get medical help right away if you have any of these problems anytime (hours to weeks) after treatment with XEOMIN:
Problems with swallowing, speaking, or breathing can happen within hours to weeks after an injection of XEOMIN if the muscles that you use to breathe and swallow become weak. Death can happen as a complication if you have severe problems with swallowing or breathing after treatment with XEOMIN.
People with certain breathing problems may need to use muscles in their neck to help them breathe and may be at greater risk for serious breathing problems with XEOMIN.
Swallowing problems may last for several months, and during that time you may need a feeding tube to receive food and water. If swallowing problems are severe, food or liquids may go into your lungs. People who already have swallowing or breathing problems before receiving XEOMIN have the highest risk of getting these problems.
Spread of toxin effects. In some cases, the effect of botulinum toxin may affect areas of the body away from the injection site and cause symptoms of a serious condition called botulism. The symptoms of botulism include: loss of strength and muscle weakness all over the body, 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.
These symptoms can happen hours to weeks after you receive an injection of XEOMIN. These problems could make it unsafe for you to drive a car or do other dangerous activities.
Do not take XEOMIN® if you: are allergic to XEOMIN or any of the ingredients in XEOMIN (see the end of this Guide for a list of ingredients in XEOMIN), had an allergic reaction to any other botulinum toxin product such as rimabotulinumtoxinB (Myobloc®), onabotulinumtoxinA (Botox®, Botox® Cosmetic), or abobotulinumtoxinA (Dysport®) or have a skin infection at the planned injection site.
Before receiving XEOMIN, tell your doctor about all of your medical conditions, including if you:
have a disease that affects your muscles and nerves (such as amyotrophic lateral sclerosis [ALS or Lou Gehrig's disease], myasthenia gravis or Lambert-Eaton syndrome)
have had any side effect from any other botulinum toxin in the past
have a breathing problem such as asthma or emphysema
have a history of swallowing problems or inhaling food or fluid into your lungs (aspiration)
have bleeding problems
have drooping eyelids
have plans to have surgery
have had surgery on your face
are pregnant or plan to become pregnant. It is not known if XEOMIN can harm your unborn baby.
are breastfeeding or plan to breastfeed. It is not known if XEOMIN passes into breast milk.
Tell your doctor about all of the medicines you take, including prescription and over-the-counter medicines, vitamins and herbal supplements. Talk to your doctor before you take any new medicines after you receive XEOMIN.
Using XEOMIN 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 XEOMIN in the past. Especially tell your doctor if you:
have received any other botulinum toxin product in the last four months
have received injections of botulinum toxin such as rimabotulinumtoxinB (MYOBLOC®), onabotulinumtoxinA (BOTOX®, BOTOX® COSMETIC) and abobotulinumtoxinA (DYSPORT®) in the past. Be sure your doctor knows exactly which product you received. The dose of XEOMIN may be different from other botulinum toxin products that you have received.
have recently received an antibiotic by injection
take muscle relaxants
take an allergy or cold medicine
take a sleep medicine
Ask your doctor if you are not sure if your medicine is one that is listed above.
Know the medicines you take. Keep a list of your medicines with you to show your doctor and pharmacist each time you get a new medicine.
Possible Side Effects
XEOMIN can cause serious side effects including: See "Warnings."
Injury to the cornea (the clear front surface of the eye) in people treated for blepharospasm. People who receive XEOMIN to treat spasm of the eyelid may have reduced blinking that can cause a sore on their cornea or other problems of the cornea. Call your healthcare provider or get medical care right away if you have eye pain or irritation after treatment with XEOMIN.
XEOMIN may cause other serious side effects including allergic reactions. Symptoms of an allergic reaction to XEOMIN may include: itching, rash, redness, swelling, wheezing, trouble breathing, or dizziness or feeling faint. Tell your doctor or get medical help right away if you get wheezing or trouble breathing, or if you get dizzy or faint.
The most common side effects of XEOMIN in people with chronic sialorrhea include:
needing to have a tooth pulled (extracted)
high blood pressure
The most common side effects of XEOMIN in people with upper limb spasticity include:
nasal congestion, sore throat and runny nose
upper respiratory infection
The most common side effects of XEOMIN in people with cervical dystonia include:
pain at the injection site
muscle and bone pain
The most common side effects of XEOMIN in people with blepharospasm include:
drooping of the eyelid
shortness of breath
nasal congestion, sore throat, and runny nose
These are not all the possible side effects of XEOMIN. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
General information about the safe and effective use of XEOMIN
Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. You can ask your pharmacist or doctor for information about XEOMIN that is written for health professionals.
Active Ingredients: botulinum toxin type A
Inactive Ingredients: human albumin and sucrose
For more information, please see XEOMIN full Prescribing Information and Medication Guide.