Access Prescribed Treatment

The ASSURE program provide a variety of support so that you can stay focused on your patients care.

*Otsuka America Pharmaceutical, Inc.

Call the ASSURE Program at 855-24-ASSURE (855-242-7787) to
request a visit from your ASSURE Program Manager

Benefit Verification Support

Streamline the process of determining your patients’ insurance coverage

ASSURE can help verify your patients’ insurance coverage and outline all access options

  • Complete and submit the ASSURE Program Enrollment form
  • ASSURE will send a fax back confirming receipt of the Enrollment Form and follow-up if there is additional information needed
  • Within 1 to 2 business days, you will receive a detailed Summary of Benefits outlining your patient’s coverage
  • ASSURE can conduct alternate insurance research to identify other sources of coverage if needed

Your dedicated site coordinator will call to explain coverage and access options available for each patient.

Prior Authorization Support

If a prior authorization is needed, ASSURE will outline the payor requirements to complete the prior authorization. ASSURE can track each prior authorization on your behalf and communicate the outcome back to your site.

Alternate Coverage Research Support

If your patient does not have coverage, ASSURE can research to see if there are alternative coverage options for your patient (i.e. state Medicaid program, State Pharmacy Assistance Program)

Other Financial Assistance

For patients who may need extra help, ASSURE can research resources that may be available to assist with patient cost-share. ASSURE can provide referrals to independent copay foundations(501c3) or provide information on how to apply for low income subsidy (LIS).

Download prior authorization forms and letter templates:


Commercial Copay Savings Program

Reduce patients’ out-of-pocket cost

Patients with commercial insurance may be eligible to receive ABILIFY MAINTENA for as low as $10 per prescription*. Call the ASSURE program for additional information.

Patients are ineligible for the copay program if they do not have a commercial insurance plan or if prescriptions are paid for in whole or in part by any government agency or benefits plan.

Exclusions apply. No cash pay patients or patients federally or state funded insurance.

*Will vary based on patients cost share requirements

Automatic copay reduction at select pharmacies:

Patients with commercial insurance may be eligible for additional savings reducing their cost share to as low as $10 per prescription. No copay card is needed; savings will automatically be applied at select pharmacies.

TO FIND A NEARBY PARTICIPATING PHARMACY, PATIENTS OR CAREGIVERS MAY VISIT eVoucherRx.RelayHealth.com/storelookup


Ordering Made Easy

Acquire medication directly from a specialty distributor when utilizing a Order and Bill option

If you are required to utilize a Order and Bill option, you can acquire ABILIFY MAINTENA through a specialty distributor. Otsuka has two authorized specialty distributors of record or you can use existing wholesalers:

Specialty Authorized Distributors

Besse Medical
P: 1-800-543-2111
F: 1-800-543-8695
www.besse.com
McKesson Specialty
P: 1-855-477-9800
F: 1-800-371-3963
www.mckessonspecialtyhealth.com


Wholesale options may also be available. Additionally, your site may qualify for reduced-price medication through the federal Minnesota Multistate Contracting Alliance for Pharmacy (MMCAP) program. Call your Assure Program Manager to learn more.

Coding and Billing Information

Receive product coding and billing information for treatment acquisition and administration

If a patient’s health insurer requires that ABILIFY MAINTENA be reimbursed through a “Buy-and-Bill” option, ASSURE can research and provide specific coding information for that health insurer.

  • ASSURE support is available for FDA approved Indications only

This resource is provided for informational purposes only and does not guarantee that billing codes will be appropriate or that coverage and reimbursement will result. Providers should consult with their payers for all relevant coverage, coding, and reimbursement requirements. It is the sole responsibility of the provider to select proper codes and ensure the accuracy of all claims used in seeking reimbursement. This resource is not intended as legal advice or a substitute for a provider’s independent professional judgment.

Benefit Verification Support

Streamline the process of determining your patients’ insurance coverage

ASSURE can help verify your patients’ insurance coverage and outline all access options

  • Complete and submit the ASSURE Program Enrollment form
  • ASSURE will send a fax back confirming receipt of the Enrollment Form and follow-up if there is additional information needed
  • Within 1 to 2 business days, you will receive a detailed Summary of Benefits outlining your patient’s coverage
  • ASSURE can conduct alternate insurance research to identify other sources of coverage if needed

Your dedicated site coordinator will call to explain coverage and access options available for each patient.

Prior Authorization Support

If a prior authorization is needed, ASSURE will outline the payor requirements to complete the prior authorization. ASSURE can track each prior authorization on your behalf and communicate the outcome back to your site.

Alternate Coverage Research Support

If your patient does not have coverage, ASSURE can research to see if there are alternative coverage options for your patient (i.e. state Medicaid program, State Pharmacy Assistance Program)

Other Financial Assistance

For patients who may need extra help, ASSURE can research resources that may be available to assist with patient cost-share. ASSURE can provide referrals to independent copay foundations(501c3) or provide information on how to apply for low income subsidy (LIS).

Download prior authorization forms and letter templates:

Commercial Copay Savings Program

Reduce patients’ out-of-pocket cost

Patients with commercial insurance may be eligible to receive ABILIFY MAINTENA for as low as $10 per prescription*. Call the ASSURE program for additional information.

Patients are ineligible for the copay program if they do not have a commercial insurance plan or if prescriptions are paid for in whole or in part by any government agency or benefits plan.

Exclusions apply. No cash pay patients or patients federally or state funded insurance.

*Will vary based on patients cost share requirements

Automatic copay reduction at select pharmacies:

Patients with commercial insurance may be eligible for additional savings reducing their cost share to as low as $10 per prescription. No copay card is needed; savings will automatically be applied at select pharmacies.

TO FIND A NEARBY PARTICIPATING PHARMACY, PATIENTS OR CAREGIVERS MAY VISIT eVoucherRx.RelayHealth.com/storelookup


Ordering Made Easy

Acquire medication directly from a specialty distributor when utilizing a Order and Bill option

If you are required to utilize a Order and Bill option, you can acquire ABILIFY MAINTENA through a specialty distributor. Otsuka has two authorized specialty distributors of record or you can use existing wholesalers:

Specialty Authorized Distributors

Besse Medical
P: 1-800-543-2111
F: 1-800-543-8695
www.besse.com
McKesson Specialty
P: 1-855-477-9800
F: 1-800-371-3963
www.mckessonspecialtyhealth.com


Wholesale options may also be available. Additionally, your site may qualify for reduced-price medication through the federal Minnesota Multistate Contracting Alliance for Pharmacy (MMCAP) program. Call your Assure Program Manager to learn more.

Coding and Billing Information

Receive product coding and billing information for treatment acquisition and administration

If a patient’s health insurer requires that ABILIFY MAINTENA be reimbursed through a “Buy-and-Bill” option, ASSURE can research and provide specific coding information for that health insurer.

  • ASSURE support is available for FDA approved Indications only

This resource is provided for informational purposes only and does not guarantee that billing codes will be appropriate or that coverage and reimbursement will result. Providers should consult with their payers for all relevant coverage, coding, and reimbursement requirements. It is the sole responsibility of the provider to select proper codes and ensure the accuracy of all claims used in seeking reimbursement. This resource is not intended as legal advice or a substitute for a provider’s independent professional judgment.

Please see U.S. FULL PRESCRIBING INFORMATION, including BOXED WARNING, and MEDICATION GUIDE, for ABILIFY MAINTENA® (aripiprazole).

To report an adverse event or product quality complaint please call: 1-800-438-9927
For all other medical inquiries, call: 1-800-441-6763

Contact Us

Call 855-24-ASSURE (855-242-7787)
8 AM - 8 PM ET, Monday through Friday

Fax 855-876-2627

Enroll in ASSURE

ASSURE Program Enrollment Form and Instructions

Sample Letters

See the ASSURE offerings come to life in this short, animated video

Please see U.S. FULL PRESCRIBING INFORMATION, including BOXED WARNING, and MEDICATION GUIDE, for ABILIFY MAINTENA® (aripiprazole).


To report an adverse event or product quality complaint please call: 1-800-438-9927
For all other medical inquiries, call: 1-800-441-6763