*Not valid if the patient is utilizing a state or federally funded health insurance program such as Medicare (including Medicare Part D), Medicaid, Medigap, VA, DoD, TRICARE®, state pharmaceutical assistance program, etc. to pay in part or in full for their QFITLIA prescription. Not valid where prohibited by law. Sanofi reserves the right to modify or terminate the Copay Program at any time without notice. Savings by patients may vary depending on their out-of-pocket costs. The program is intended to help patients afford their QFITLIA prescription. Patients may have insurance plans that attempt to dilute the impact of the assistance available under the program. In those situations, the program may change its terms.
† Claims for free products dispensed through the Bridge or Patient Assistance Programs shall not be submitted to any third-party payer, public or private (e.g. private insurance, Medicaid, Medicare, VA, DoD, TRICARE®, or similar federal or state programs) for reimbursement. All Programs not valid where prohibited by law. Sanofi reserves the right to modify or terminate the Programs at any time without notice. Program details provided upon registration.
