Want name-brand LIPITOR
for $1 a day or less?*†
By George, you can have it.
*Terms and Conditions apply. See next page.
You may pay less by receiving the generic.
Introducing the LIPITOR Choice Card.
Brought to you by P;zer,
the makers of name-brand LIPITOR.
With this card you may pay as little as $4 a month depending on insurance.
‡Patients with Medicare Part D plan must agree not to use any prescription benefits to
You pay if you have: $4 You pay if you have: $30
Other commercial/private insurance,
Medicare Part D,‡ or no insurance.
Commercial/private insurance with an
out-of-pocket expense of $130 or less
for a 30-day supply of LIPITOR.
*LIPITOR CHOICE CARD TERMS AND CONDITIONS
By using the LIPITOR Choice Card (the “Card”), you
attest that you meet the eligibility criteria and will
comply with the Terms and Conditions described below:
You will pay $4 for a 30-day supply ( 30 tablets) if:
you use commercial/private insurance and your out-of-pocket expense for a 30-day supply of name-brand
LIPITOR is $130 or less.
You will pay $30 for a 30-day supply ( 30 tablets)
if: you do not use prescription health coverage to
purchase your name-brand LIPITOR under this program
or you use commercial/private insurance and your out-of-pocket expense for a 30-day supply of name-brand
LIPITOR is $130 or more. In addition:
a. Medicare Part D patients may participate in
this Card Program, but cannot use any part of
their Medicare Part D prescription bene;t for
LIPITOR during the term of this offer.
b. Out-of-pocket expenditures under this
Card Program cannot be applied towards
a patient’s Medicare Part D true out of
pocket (TrOOP) expenses.
c. Patients participating in this category cannot
seek reimbursement for a purchase of LIPITOR
from any third party insurance entity during the
term of this offer.
This offer is not valid for prescriptions that are eligible to
be reimbursed, in whole or in part, by Medicaid or other
federal or state healthcare programs (including any
state prescription drug assistance programs and the
Government Health Insurance Plan available in Puerto
Rico [formerly known as “La Reforma de Salud”]).
For all eligible patients, you can only qualify for up to
$2500 of savings per calendar year. After a maximum of
$2500, you will pay usual monthly out-of-pocket costs.
This Card cannot be combined with any other rebate/
coupon, free trial, discount, prescription savings card,
or similar offer for the speci;ed prescription.
The Card will be accepted only at participating
This Card is not health insurance.
Offer valid only in the U.S. and Puerto Rico, but not
for Massachusetts residents or where otherwise
prohibited by law.
The Card is limited to 1 use per person per month
during this offering period and is not transferable. It is
illegal to sell, purchase, trade, or counterfeit or offer
to sell, purchase, trade, or counterfeit, this Card.
P;zer reserves the right to rescind, revoke or amend
the Card Program without notice at any time.
You must be 18 or older to participate in this Program.
Card Program expires December 31, 2015.
No membership fees.
For reimbursement when using mail order, mail copy
of original pharmacy receipt (cash register receipt NOT
valid) with product name, date and amount circled to:
LIPITOR Choice Card
14001 Weston Parkway, Suite 103
Cary, NC 27513-9967
Be sure to include a copy of the front of your Choice
Card, your name and mailing address.
LEP668817 © 2014 P;zer Inc. All rights reserved. Printed in USA/August 2014