You've already taken an important step in managing your health by learning more about CIMZIA® and CIMplicity®. CIMZIA offers a comprehensive patient support program called CIMplicity. You can get up to 12 months of CIMZIA with no out-of-pocket costs to you with the CIMZIA Co-Pay Savings Card. UCB offers help with co-pay assistance through the CIMZIA Co-Pay Savings Card. The CIMZIA Co-Pay Savings Card provides instant savings to eligible CIMZIA patients right at the pharmacy counter. You must have a CIMZIA prescription and meet the eligibility requirements below to participate in the CIMZIA Co-Pay Savings Card program.*

To activate your CIMZIA Co-Pay Savings Card, simply fill out the form below and enter the RxID # found on the CIMZIA Co-Pay Savings Card. If you don't have a CIMZIA Co-Pay Savings Card, you may also request to have one mailed to you by filling out the form below. After the year is complete, you can request another savings card to continue to benefit from the savings.

Patients with additional financial challenges may qualify for a free product program, the Patient Assistance Program (PAP). Call 1-866-4-CIMZIA for more information.

We will protect your privacy in accordance with current regulations, UCB's Privacy Policy, and consent. All of the information you provide today will be kept strictly confidential.
 

Consent To Use
By activating this card you agree that the information you provided may be used by UCB, the makers of CIMZIA, and its contracted third parties, to provide you with information on your disease and related treatments, products, and services, and for marketing and information purposes. UCB will not sell your name or contact information to any third party for their marketing purposes.





*Subject to eligibility. Restrictions may apply. In 2011, 96.8% of CIMZIA Co-Pay Savings Card users paid no out-of-pocket costs. The CIMZIA Co-Pay Savings Card program is valid for out-of-pocket expenses for CIMZIA for up to 17 uses. The CIMZIA Co-Pay Savings Card program is not valid for prescriptions that are reimbursed, in whole or part, under Medicare (including Medicare Part D), Medicaid, similar federal- or state-funded programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico), private insurance in the Commonwealth of Massachusetts, or where otherwise prohibited by law. Product dispensed pursuant to program rules and federal and state laws. Claims should not be submitted to any public payor (i.e., Medicare, Medicaid, Medigap, Tricare, VA and DoD) for reimbursement. The parties reserve the right to amend or end this program at any time without notice.

See terms and conditions