FOR COMMERCIALLY INSURED PATIENTS

Prescribe with Confidence. Your Patients are Covered.

Expanding Commercial Coverage

A majority of patients with commercial insurance have formulary coverage for Taltz

Taltz will replace Cosentyx^®(secukinumab) on the OptumRx National Formulary¹

Taltz is now covered on the OptumRx Commercial formularies with the status of preferred IL-17A antagonist across all indications.^1,†

There are four national formularies:

• OptumRx Select
• OptumRx Select with Focused UM
• OptumRx Premium
• OptumRx Premium Comprehensive

Taltz is now designated a Tier 3 drug.

Additional Formulary Plan Information

The information in this communication is subject to change without notice.

The information provided in this communication is not a guarantee of coverage or payment (partial or full). Actual benefits are determined by each plan administrator in accordance with its respective policy and procedures. Nothing herein may be construed as an endorsement, approval, recommendation, representation or warranty of any kind by any plan or insurer referenced herein. This communication is solely the responsibility of Lilly USA, LLC.

The formulary information does not include generic medications in this therapeutic class.

This list may not be an exhaustive list of all plans in your area and the coverage of other plans in your area may vary.

Employers and employer groups may also offer additional benefit designs which may be different than described.

Lilly USA, LLC does not endorse any particular plan. Other product and company names mentioned herein are the trademarks of their respective owners.

The formulary information in this document is for select products that share an approved indication with Taltz^® (ixekizumab).Inclusion of a product in this information does not establish clinical comparability of the products for any or all indications and should not be seen as making any claim regarding efficacy or safety.

UM=utilization management

†Effective January 1, 2020

INDICATIONS

Taltz is indicated for your adult patients with active psoriatic arthritis (PsA) and active ankylosing spondylitis (AS).
Taltz is also indicated for your adult patients with moderate to severe plaque psoriasis (PsO) who are candidates for systemic therapy or phototherapy.

SELECT IMPORTANT SAFETY INFORMATION
CONTRAINDICATIONS

Taltz is contraindicated in patients with a previous serious hypersensitivity reaction, such as anaphylaxis, to ixekizumab or to any of the excipients.

FOR COMMERCIALLY INSURED PATIENTS

Taltz Clear Access Program

But national coverage may not translate into individual patient access. The Taltz Clear Access Program can ensure the treatment choice stays between you and your patient.

^*Terms and Conditions: Offer good for up to 36 months from patient qualification into the program or until 12/31/2023, whichever comes first, provided patient continues to meet program terms and conditions. Patients must first use their card by 12/31/2020. Patient must have coverage for Taltz with their commercial drug insurance to pay as little as $5 monthly for a 28-day supply of Taltz, subject to a monthly cap of wholesale acquisition cost plus usual and customary pharmacy charges and a separate $16,000 maximum annual cap. Patient must have commercial drug insurance and a prescription consistent with FDA approved product labeling to pay as little as $25 monthly for a 28-day supply of Taltz, subject to a monthly cap of wholesale acquisition cost plus usual and customary pharmacy charges. Continued participation in the $25 program requires submission of a prior authorization (PA) before the 2nd month fill and, if coverage is denied, an appeal must be submitted prior to 5th month fill. A new PA and appeal or medical exception (ME) must be submitted every 12 months to verify coverage status and potential eligibility for the $5 program. Participation in the program requires a valid patient HIPAA authorization. Patient is responsible for any applicable taxes, fees, or amounts exceeding monthly or annual caps. This offer is invalid for patients without commercial drug insurance or those whose prescription claims are eligible to be reimbursed, in whole or in part, by any governmental program, including, without limitation, Medicaid, Medicare, Medicare Part D, Medigap, DOD, VA, TRICARE^®/CHAMPUS, or any state patient or pharmaceutical assistance program. Offer void where prohibited by law and subject to change or discontinue without notice. Card activation is required. Subject to additional terms and conditions, which can be found here.

Other product/company names are the property of their respective owner.

^§Contingent upon a patient scheduling a delivery with a specialty pharmacy.

^ǁConstitutes that a prior authorization has been submitted.

^¶Shipment can be authorized within 2 business days of submitting a prescription to either a participating specialty pharmacy or Taltz Together™ and commercial insurance is verified; patient enrolls in the Taltz Savings Card program and schedules shipment.

Network of Specialty Pharmacies

FOR COMMERCIALLY INSURED PATIENTS

Access Taltz through a specialty pharmacy that is convenient for patients

Choose a specialty pharmacy that fits prescription process needs

^*Government beneficiaries excluded. Terms and conditions apply. See full details here.

Taltz Specialty Pharmacy Network Partners

You can start the enrollment process for your patients using one of the Taltz contracted specialty pharmacies or through Taltz Together^™.

If using a specialty pharmacy, first make sure it is on the list of Taltz contracted specialty pharmacies^*. Many specialty pharmacies offer enrollment forms on their website. Submit the completed specialty pharmacy enrollment form or the Taltz enrollment form to one of the contracted specialty pharmacies. If the preferred specialty pharmacy is not included in the Taltz network, submit the enrollment form to Taltz Together for assistance. If you have questions, your Taltz sales representative will be able to assist you.

^*To access the list of contracted specialty pharmacies in Puerto Rico, please contact your local sales representative.

Support

Offerings include:

References: 1. Data on File. Lilly USA, LLC. DOF-IX-US-0187.