WHAT IF I CAN'T AFFORD RAPAFLO®?

RAPAFLO® Patient Assistance Program

The RAPAFLO® Patient Assistance Program (PAP) helps
uninsured patients gain access to RAPAFLO®. Eligibility for
PAP is determined based on various medical and
financial qualifications.

ELIGIBILITY CRITERIA:

  • Patient must be a U.S. resident
  • Patient must have an FDA-approved diagnosis
  • Patient's household income must be less than 200%
    of the Federal Poverty Limit
  • Patient must have no prescription insurance coverage

RAPAFLO® Reimbursement Assistance Program

The RAPAFLO® Reimbursement Assistance Program is
designed to help providers and patients understand insurance
coverage for RAPAFLO®. This program assists in contacting
insurance carriers, obtaining and providing cost-sharing
information, specialty pharmacy information,
prior authorizations, and more.

Per 30-capsule supply. Offer expires 3/31/2016. Actavis reserves the right to rescind, revoke, or amend this offer without notice at any time.
  • COMMON QUESTIONS
    How much is my co-pay with the RAPAFLO® Savings Card?

    When patients with commercial prescription drug insurance sign up for a RAPAFLO® Savings Card, they will pay no more than $15 (per 30-capsule supply) for each RAPAFLO® prescription they fill through March 31, 2016.

    Or patients with a 90-day prescription and RAPAFLO® Savings Card can pay no more than $40 (per 90-capsule supply), and save an additional $5 vs a 30-day prescription.

    By using the RAPAFLO® Savings Card, you agree that your personal information may be used for eligibility verification and to process your savings.

    Do I need to activate my card?

    If you have already received a card from your urologist or health care provider, you need to activate your card to pay no more than $15 per month (per 30-capsule supply). If you do not activate your card, it will not work at the pharmacy. If you signed up for the pay no more than $15 Savings Card online and received a confirmation email, then it is already activated and ready for use.

    Is the RAPAFLO® Savings Card widely accepted at pharmacies?

    Yes, the RAPAFLO® Savings Card can be used at most retail pharmacies. If you experience any difficulty using the card, please call 1-855-276-2952.

    How do I use the RAPAFLO® Savings Card?

    Saving with your card is simple.

    1. Sign up for a $15* Savings Card.
    2. Present a valid prescription for RAPAFLO® to your pharmacist, along with your RAPAFLO® Savings Card.
    3. Use your card each time you fill your prescription as long as you remain eligible, and for as long as the program remains active.

    Make sure to follow your health care professional's instructions for taking RAPAFLO®. Call your health care professional if you experience any problems.

    *Per $30-capsule supply, Offer expires 3/31/16. Actavis reserves the right to rescind, revoke, or amend this offer without notice at any time.

    Can I use the RAPAFLO® Savings Card at a mail order pharmacy?

    Yes, a mail order benefit is available for patients with commercial prescription drug insurance. Fill out your mail order prescription and follow the instructions listed below:

    • Send your name, address, city, state, ZIP, phone number, date of birth, and the amount of your out-of-pocket payment
    • Provide the Group # and 11-digit ID # from the lower left-hand corner of the RAPAFLO® Savings Card
    • Enclose the original proof of purchase (original pharmacy receipt with pharmacy name, product name, prescription number, date filled, and the price)

    Mail all of the above to: RAPAFLO® Savings Card
    PO Box 7017, Bedminster, NJ 07921-7017

    On the back of my card, and in a few other places, it says "commercial prescription drug insurance." What does that mean?

    Having commercial prescription drug insurance means no portion of your RAPAFLO® prescription cost will be submitted for reimbursement to a federally or state-funded prescription drug benefit program, such as Medicare, Medicaid, Medigap, VA, DOD or Tricare, or any private indemnity or HMO insurance plan that reimburses you for the entire cost of your prescription drugs.

    You also cannot be Medicare-eligible and enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees.

    If you begin receiving prescription benefits from one of these types of programs at any time, you will no longer be eligible to participate in this savings program.

    If you do not have commercial prescription drug insurance, you cannot use a RAPAFLO® Savings Card. Find out how you can still save with the Patient Assistance Program.

    How do I know if I’m eligible for Patient Assistance?

    You are eligible for the Patient Assistance Program if you:

    • Are a US resident
    • Have an FDA-approved diagnosis
    • Have a household income less than 200% of the Federal Poverty Limit
    • Have no insurance coverage
See More

INDICATIONS AND USAGE

RAPAFLO® (silodosin) capsules are indicated for the treatment of the signs and symptoms of benign prostatic hyperplasia (BPH).

RAPAFLO® is not indicated for the treatment of hypertension.

IMPORTANT RISK INFORMATION

RAPAFLO® is available only by prescription and is approved to treat male urinary symptoms due to BPH, also called an enlarged prostate. RAPAFLO® should not be used to treat high blood pressure.

Only your doctor can tell if you have BPH, not a more serious condition like prostate cancer. RAPAFLO® should not be used in patients with severe liver or kidney disease as well as those taking certain antifungal or HIV drugs. Do not take RAPAFLO® if you know you are allergic to it or any of its ingredients.

Avoid driving or hazardous tasks until you know how RAPAFLO® will affect you, as a sudden drop in blood pressure may occur, rarely resulting in fainting. If considering cataract surgery, tell your eye surgeon you're currently taking RAPAFLO® or have taken it in the past.

Side effects include a decrease or absence of semen during sex, dizziness, diarrhea, lightheadedness upon standing or sitting up abruptly, headache, swelling of the throat and nasal passages, and stuffy nose.

Please view the full Prescribing Information for RAPAFLO®.

RAPAFLO® and its design are registered trademarks of Actavis, Inc.

  • REFERENCES
    1. National Institute of Diabetes and Digestive and Kidney Diseases. Prostate enlargement: benign prostatic hyperplasia.
      NIH Publication No. 07-3012. June 2006.
    2. RAPAFLO® (silodosin) Capsules full Prescribing Information, Parsippany, NJ: Watson Pharma, Inc. January 2013.
    3. Marks LS, Gittelman MC, Hill LA, Volinn W, Hoel G. Rapid efficacy of the highly selective α1A-adrenoceptor antagonist silodosin in men with signs and symptoms of benign prostatic hyperplasia: pooled results of 2 phase 3 studies. J Urol. 2009;181:2634-2640.
    4. Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. J Urol. 1984;132:474.
    5. Roehrborn CG, Kaplan SA, Lepor H, Volinn W. Symptomatic and urodynamic responses in patients with reduced or no seminal emission during silodosin treatment for LUTS and BPH. Prostate Cancer Prostatic Dis. 2011;14:143-148.
    6. Shvartzman P, Borkan JM, Stoliar L, et al. Second-hand prostatism: effects of prostatic symptoms on spouses’ quality of life, daily routines and family relationships. Family Pract. 2001;18:610-613.
    7. Data on file, Watson Laboratories, Inc.
    8. Marks LS, Gittelman MC, Hill LA, Volinn W, Hoel G. Silodosin in the treatment of the signs and symptoms of benign prostatic hyperplasia:
      a 9-month, open-label extension study. Urology. 2009;74:1318-1322.
    9. Cunha, JP. Frequent urination. eMedicine Health from WebMD. Available at: http://www.emedicinehealth.com/frequent_urination/article_em.htm. Accessed April 22, 2013.
    10. Issa MM, Regan T. Medical therapy for benign prostatic hyperplasia—present and future impact. Am J Manag Care. 2007;13:S4-S9.
    11. Fenter TC, Naslund MJ, Shah MB, Eaddy MT, Black L. The cost of treating the 10 most prevalent diseases in men 50 years of age or older.
      Am J Manag Care. 2006;12(4 suppl):S90-S98.
    12. American Urological Association. AUA guideline on management of benign prostatic hyperplasia (2003). Chapter 1: Diagnosis and treatment recommendations. J Urol. 2003;170:530-547.
    13. Medline Plus Medical Encyclopedia from NIH: Enlarged prostate. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000381.htm. Accessed July 29, 2010.
    14. de Mey C, Michel MC, McEwen J, Moreland T. A double-blind comparison of terazosin and tamsulosin on their differential effects on ambulatory blood pressure and nocturnal orthostatic stress testing. Eur Urol. 1998;33:481-488.
    15. Milani S, Djavan B. Lower urinary tract symptoms suggestive of benign prostatic hyperplasia: latest update on α1-adrenoceptor antagonists. BJU Int. 2005;95(Suppl 4):29-36.
    16. Kobayashi K, Masumori N, Hisasue S, et al. Inhibition of seminal emission is the main cause of an ejaculation induced by a new highly selective α1A-blocker in normal volunteers. J Sex Med. 2008;5:2185-2190.
    17. Kaplan SA. Side effects of α-blocker use: retrograde ejaculation. Rev Urol. 2009;11(Suppl 1):S14-S18.
    18. JALYN (dutasteride and tamsulosin hydrochloride) Capsules full Prescribing Information, GlaxoSmithKline, October 2012.
    19. Rosen RC, Giuliano F, Cason CC. Sexual dysfunction and lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Eur Urol. 2005;47:824-837.
    20. Bruskewitz RC. Quality of life and sexual function in patients with benign prostatic hyperplasia. Rev Urol. 2003;5:72-80.
    21. Kaplan S, Roehrborn CG, Hill LA, Volinn W. Effect of estimated prostate volume on silodosin-mediated improvements in the signs and symptoms of BPH: does prostate size matter? Open Access J Urol. 2011;3:89-93.
    22. American Urological Association Foundation. Prostate Health Playbook. AUA Foundation. 2011. Available at: http://www.urologyhealth.org/_media/_pdf/KYS%20Playbook%2012-11.pdf. Accessed May 17, 2013.
    23. Ponholzer A, Madersbacher S. Lower urinary tract symptoms and erectile dysfunction; links for diagnosis, management and treatment.
      Int J Impot Res. 2007;19:544-550.
    24. Kuritzky L. A primary care physician’s perspective on benign prostatic hyperplasia. Rev Urol. 2003;5(suppl 5):S42-S48.
    25. Wolters R, Wensing M, Van Weel C, Van Der Wilt GJ, Grol RPTM. Lower urinary tract symptoms: social influence is more important than symptoms in seeking medical care. BJU Int. 2002;90:655-661.