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Proven effective through 16 hours1-3
Eligible patients can save up to 50% on their first LASTACAFT® prescription, plus another $5 if they fill it within 7 days of the prescription date. They can also save up to 50% on their second LASTACAFT® prescription, and up to 100% on their third. Your patient’s total savings can be up to $250!*

This offer is not valid for people participating in Medicare, Medicaid, or any similar federal or state healthcare program, including any state medical or pharmaceutical assistance programs. Test preprod

Coupon is good for up to 3 prescriptions. This promotion cannot be combined with any other programs, offers, or discounts. Coupon expires December 31, 2015.

The patient education brochure contains valuable information about LASTACAFT® (alcaftadine ophthalmic solution) 0.25%.
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Patient: You must present this card to the pharmacist along with your prescription to participate in this program. This card is good for up to 50% off the first and second prescription of LASTACAFT® (alcaftadine ophthalmic solution) 0.25%, not to exceed $75 per prescription. The third prescription is covered up to 100%, not to exceed $100. Total savings on all 3 prescriptions not to exceed $250. In addition, you can save up to an extra $5 if you fill your prescription within 7 days of the date it is prescribed. This card must be presented at the time of each fill for instant savings. Offer is only good at participating retailers. For any questions, call the LASTACAFT® Savings Program at 1-855-276-2950.

Eligibility: 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 coupon. Offer void where prohibited by law, taxed, or restricted. This promotion cannot be combined with any other programs, offers, or discounts. Offer good only in the United States. Allergan, Inc., reserves the right to rescind, revoke, and amend this offer without notice.

Pharmacist instructions for a patient with an Eligible Third Party: Submit the claim to the primary Third Party Payer first, then submit the balance due to Therapy First Plus as a Secondary Payer COB (coordinator of benefits) with the patient responsibility amount and a valid Other Coverage Code (eg, 8). The patient payment amount will be reduced by 50%, up to $75, on the first and second prescription, and by 100%, up to $100, on the third prescription. Reimbursement will be received from Therapy First Plus.

Pharmacist instructions for a cash-paying patient: Submit this claim to Therapy First Plus. A valid Other Coverage Code (eg, 1) is required. The patient payment amount will be reduced by 50%, up to $75, on the first and second prescription, and by 100%, up to $100, on the third prescription. Reimbursement will be received from Therapy First Plus.

Valid Other Coverage Code required.

For any questions regarding Therapy First Plus online processing, please call the Help Desk at
1-800-422-5604.

Offer expires December 31, 2015. Good for up to 3 prescriptions.