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Support Services
- Download the Prescription and Service Request Form (PSRF)
- Fax the completed form to Shared Solutions® at 1-844-257-6127
Patients can call 1-800-887-8100, Monday–Friday, 8 am–6 pm CT.
Coupon for AJOVY
Commercially insured eligible patients can use the Savings Offer for AJOVY, which may cost as little as $5 for each prescription*
When you start a patient on AJOVY, please be sure that you provide your patients with a Savings Card to help ensure they receive this offer.
If the patient does not have insurance or does not otherwise qualify for the Savings Offer for AJOVY, there are other financial assistance programs available through Shared Solutions® for which the patient may qualify.
*Out-of-pocket costs may vary based on insurance coverage. Limitations apply. Please note, this offer is not available for patients eligible for Medicare, Medicaid, or any other form of government insurance. See full Terms and Conditions for eligibility and restrictions.
†Quarterly dosing option 675 mg (225 mg x 3) subcutaneous or Monthly dosing option 225 mg subcutaneous.
Support Services
- Download the Prescription and Service Request Form (PSRF)
- Fax the completed form to Shared Solutions® at 1-844-257-6127