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GET SAVINGS FROM QNASL

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Take Advantage of This Great Offer

Pay as little as $15 per month on QNASL*


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*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 public payer coverage. See full Terms and Conditions for eligibility and restrictions.

Savings Offer Terms and Conditions

Commercially Insured Patients with coverage may pay as little as $15 per device for their prescription of QNASL with a maximum benefit $98.10 per device. Maximum Reimbursement limits apply and out of pocket expenses may vary. Commercially Insured patients whose insurance does not cover QNASL will pay $75 per device for their prescription of QNASL. Teva will pay the remaining balance. Non-insured and cash-paying patients: Teva will pay up to $98.10 per device. Maximum Reimbursement limits apply and out of pocket expenses may vary.

Patients are not eligible if prescriptions are paid for in part or full by any state or federally funded programs, including but not limited to Medicare, Medicaid, Medigap, VA, DOD, TRICARE, or by private health benefit programs which reimburse for the entire cost of prescription drugs. This card is not valid for patients who are Medicare eligible and are enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees (i.e., patients who are eligible for Medicare Part D but receive a prescription drug benefit through a former employer). Cash Discount Cards and other non-insurance plans are not valid as primary under this offer. If the patient is eligible for drug benefits under any such program, the patient cannot use this offer. By redeeming this offer, the patient certifies that he or she will comply with any terms of his or her health insurance contract requiring notification to his or her payor of the existence and/or value of this offer and that the patient is eligible for, and will comply with, the terms of this offer. By redeeming this offer, the patient and the pharmacist acknowledge that the patient is eligible, and the patient and pharmacist understand and agree to comply with the Terms and Conditions of this offer. If the patient is a minor, this offer must be redeemed by the patient’s parent, guardian or caregiver. Offer not valid for patients under 4 years of age.

Void if copied, transferred, purchased, altered or traded and where prohibited and restricted by law. This is not an insurance program. Valid only in the United States including the Commonwealth of Puerto Rico. This offer may not be used with any other discount, coupon or offer. This offer expires on December 31, 2019. This program is managed by ConnectiveRx on behalf of Teva Pharmaceuticals USA, Inc. Teva reserves the right to limit, change or discontinue this offer at any time without notice. If you have any questions regarding your eligibility or benefits, please call 833-378-7362.

To the Patient: Commercially-Insured: In order to redeem this offer you must have a valid prescription for QNASL. Follow the dosage instructions given by the doctor. This offer must be presented along with your prescription for QNASL and your primary insurance card. Non-Insured/Cash Paying Patients: In order to redeem this offer you must have a valid prescription for QNASL. Follow the dosage instructions given by the doctor. This offer must be presented along with your prescription for QNASL. Patients with questions about the QNASL Savings Offer should call 833-378-7362.

To the Pharmacist: By redeeming this offer, the Pharmacist certifies that QNASL is being dispensed to a patient eligible for this offer in compliance with these Terms and Conditions and the Pharmacy has not submitted and will not submit a claim for reimbursement under any federal, state, or other governmental program for this prescription. For any questions regarding Change Healthcare online processing, please call the Help Desk at 1-800-422-5604. For Commercially-Insured Patients: Please submit this claim to the primary Third-Party Payer first, then submit the balance due to Change Healthcare as a Secondary Payer COB (coordination of benefits) with patient responsibility and a valid Other Coverage Code (e.g. 8). Reimbursement will be received from Change Healthcare. For Insured/Not Covered: Patients who have commercial insurance but you receive a “not covered” response because QNASL is not on the patient’s formulary or is subject to prior authorization or step therapy and the patient has not met the criteria, continue the claim adjudication process and run the claim as secondary payer COB with the patient responsibility amount and a valid Other Coverage Code (e.g., 03). For Cash-Paying Patients: Please submit this claim to Change Healthcare. A valid Other Coverage Code (e.g., 01) is required. For QNASL, the patient’s card will have a value of $98.10 per device towards their prescription. Reimbursement will be received from Change Healthcare.

APPROVED USES

QNASL® (beclomethasone dipropionate) Nasal Aerosol is a prescription medication that treats seasonal nasal and year-round nasal allergy symptoms in patients 4 years of age and older. Read Important Safety Information

IMPORTANT SAFETY INFORMATION
  • In clinical studies, nosebleeds and nose ulcers were more common in patients treated with QNASL Nasal Aerosol than patients who received placebo. Some nosebleeds were more severe in patients treated with QNASL Nasal Aerosol than in patients who received placebo. Tell your healthcare provider if you start to have nosebleeds or nasal ulcers after using QNASL Nasal Aerosol.
  • Thrush (Candida), a fungal infection in your nose, mouth, or throat may occur. Tell your healthcare provider if you have any redness or white colored patches in your mouth or throat.
  • You should avoid using QNASL Nasal Aerosol until your nose is healed if you have a sore in your nose, you have had recent surgery on your nose, or if your nose has been injured, because QNASL Nasal Aerosol may cause slow wound healing.
  • Some people who use corticosteroids may have eye problems such as blurred vision, increased pressure in the eye (glaucoma) or cataracts. If you have a history of blurred vision, glaucoma or cataracts or have a family history of eye problems, you should have regular eye exams while you use QNASL Nasal Aerosol.
  • Serious allergic reactions can happen in people taking QNASL Nasal Aerosol. Stop using QNASL Nasal Aerosol and call your healthcare provider right away or get emergency help if you experience shortness of breath or trouble breathing, skin rash, redness, swelling, severe itching, or swelling of your lips, tongue or face.
  • People are more likely to get infections if they have immune system problems or use drugs, including corticosteroids, which may weaken the body’s ability to fight infections. Avoid contact with people who have infections like chickenpox or measles while using QNASL Nasal Aerosol. Speak to your healthcare provider before using QNASL Nasal Aerosol if you have tuberculosis or untreated fungal, bacterial, or viral infections, or eye infections caused by herpes. Symptoms of an infection include: fever, pain, aches, chills, feeling tired, nausea and vomiting.
  • A condition in which the adrenal glands do not make enough steroid hormones may occur. Symptoms can include tiredness, weakness, dizziness, nausea and vomiting. Tell your healthcare provider if you experience these symptoms.
  • Children taking QNASL Nasal Aerosol should have their growth checked regularly, since corticosteroids may slow growth in children.
  • The most common side effects with QNASL Nasal Aerosol 80 mcg in patients 12 years of age and older are nasal discomfort, nosebleeds, and headache.
  • The most common side effects with QNASL Nasal Aerosol 40 mcg in patients 4 to 11 years of age are headache, fever, infection of the nose and throat, and inflammation of the nose and throat.
  • Tell your healthcare provider if you have any side effect that bothers you or that does not go away.
  • These are not all of the possible side effects of QNASL Nasal Aerosol. For more information, ask your healthcare provider or pharmacist.

Please see full QNASL Prescribing Information.

Please see full QNASL (with Primeless Valve) Prescribing Information.

APPROVED USES

QNASL® (beclomethasone dipropionate) Nasal Aerosol is a prescription medication that treats seasonal nasal and year-round nasal allergy symptoms in patients 4 years of age and older. Read Important Safety Information

IMPORTANT SAFETY INFORMATION
  • In clinical studies, nosebleeds and nose ulcers were more common in patients treated with QNASL Nasal Aerosol than patients who received placebo. Some nosebleeds were more severe in patients treated with QNASL Nasal Aerosol than in patients who received placebo. Tell your healthcare provider if you start to have nosebleeds or nasal ulcers after using QNASL Nasal Aerosol.
  • Thrush (Candida), a fungal infection in your nose, mouth, or throat may occur. Tell your healthcare provider if you have any redness or white colored patches in your mouth or throat.
  • You should avoid using QNASL Nasal Aerosol until your nose is healed if you have a sore in your nose, you have had recent surgery on your nose, or if your nose has been injured, because QNASL Nasal Aerosol may cause slow wound healing.
  • Some people who use corticosteroids may have eye problems such as blurred vision, increased pressure in the eye (glaucoma) or cataracts. If you have a history of blurred vision, glaucoma or cataracts or have a family history of eye problems, you should have regular eye exams while you use QNASL Nasal Aerosol.
  • Serious allergic reactions can happen in people taking QNASL Nasal Aerosol. Stop using QNASL Nasal Aerosol and call your healthcare provider right away or get emergency help if you experience shortness of breath or trouble breathing, skin rash, redness, swelling, severe itching, or swelling of your lips, tongue or face.
  • People are more likely to get infections if they have immune system problems or use drugs, including corticosteroids, which may weaken the body’s ability to fight infections. Avoid contact with people who have infections like chickenpox or measles while using QNASL Nasal Aerosol. Speak to your healthcare provider before using QNASL Nasal Aerosol if you have tuberculosis or untreated fungal, bacterial, or viral infections, or eye infections caused by herpes. Symptoms of an infection include: fever, pain, aches, chills, feeling tired, nausea and vomiting.
  • A condition in which the adrenal glands do not make enough steroid hormones may occur. Symptoms can include tiredness, weakness, dizziness, nausea and vomiting. Tell your healthcare provider if you experience these symptoms.
  • Children taking QNASL Nasal Aerosol should have their growth checked regularly, since corticosteroids may slow growth in children.
  • The most common side effects with QNASL Nasal Aerosol 80 mcg in patients 12 years of age and older are nasal discomfort, nosebleeds, and headache.
  • The most common side effects with QNASL Nasal Aerosol 40 mcg in patients 4 to 11 years of age are headache, fever, infection of the nose and throat, and inflammation of the nose and throat.
  • Tell your healthcare provider if you have any side effect that bothers you or that does not go away.
  • These are not all of the possible side effects of QNASL Nasal Aerosol. For more information, ask your healthcare provider or pharmacist.