This information is intended for US Residents ages 18 and older.

Trulicity® (dulaglutide)  
 

Pay as little as $25 per prescription

Commercially insured patients may pay as little as $25 for up to 12 pens of Trulicity.

If you have questions, we're here to help. Call The Lilly Answers Center at 1-844-TRU-INFO (1-844-878-4636). You can also call if you fill your prescription through mail order and need reimbursement information. Your card expires for redemption refills on December 31, 2022.

THIS OFFER IS INVALID FOR PATIENTS WHOSE PRESCRIPTION CLAIMS ARE ELIGIBLE TO BE REIMBURSED, IN WHOLE OR IN PART, BY ANY GOVERNMENTAL PROGRAM.

See below for Terms and Conditions and Pharmacist Instructions.

Please see full Prescribing Information and Medication Guide including Boxed Warning provided by pharmacist.

RxBIN: 018844
PCN: 3F
Group: TRUDTCEM2
Identification: TALM8857430
Expiration Date: 12/31/2022

Terms and Conditions:

By using the Trulicity Savings ("Card"), you attest that you meet the eligibility criteria, agree to and will comply with the terms and conditions described below:

Offer good until 12/31/2022 for up to 12 months of Trulicity. Patients must have coverage for Trulicity through their commercial drug insurance coverage to pay as little as $25 for up to 12 pens of Trulicity. Offer subject to a monthly cap of $150 and a separate annual cap of $1800. Offer void where prohibited by law. Patient is responsible for any applicable taxes, fees, or amounts exceeding monthly or annual caps. This offer is invalid for patients without commercial drug insurance or whose prescription claims for Trulicity are eligible to be reimbursed, in whole or in part, by any governmental program, including, without limitation, Medicaid, Medicare, Medicare Part D, Medigap, DoD, VA, TRICARE®/CHAMPUS, or any state patient or pharmaceutical assistance program. This offer is not valid for: Massachusetts residents if an AB-rated generic equivalent is available; California residents if an FDA-approved therapeutic equivalent is available. Available only in the US and Puerto Rico for residents of the US and Puerto Rico. By accepting this offer, you agree that if you are required to do so under the terms of your insurance coverage for this prescription or are otherwise required to do so by law, you should notify your insurance carrier of your redemption of this Card. This offer cannot be combined or utilized with any other program, discount, discount card, cash discount card, coupon, incentive, or similar offer involving Trulicity. It is prohibited for any person to sell, purchase or trade; or to offer to sell, purchase or trade, or to counterfeit this Card. This offer may be terminated, rescinded, revoked or amended by Lilly USA, LLC at any time without notice. Card activation required. This Card is not health insurance. This Card expires on 12/31/2022.

To the Pharmacist:

  • This card must be accompanied by a valid prescription for Trulicity and can only be used by one patient. By accepting this offer, you certify that you understand and agree to comply with the offer terms set forth herein.
  • If you are required to do so under the terms of your third-party payer contracts or as otherwise required by law, you should notify the affected third-party payer of your redemption of this offer
  • This offer is valid for commercially insured patients only. Offer is not valid for patients who are eligible to have their prescriptions reimbursed in whole or part by any governmental program
  • Please return card to patient after claim is processed
  • Transmit claim online to RxBIN 018844. Processor requires valid Prescriber ID #, PCN, Patient Name, and DOB for claim adjudication
  • Card may be used for up to 14 fills of Trulicity
  • For Insured/Covered Patients - Submit the co-pay authorized by the patient's primary insurance as a secondary claim to Eversana using BIN 018844 and using the Coordination of Benefits fields with Coverage Code type 08. This will reduce the eligible patient's out-of-pocket costs to pay as little as $25, subject to monthly and annual savings caps for the program.
  • Pharmacists with questions, please call the Pharmacy Benefit Manager 1-855-282-4888

PURPOSE AND SAFETY SUMMARY WITH WARNINGS

Important Facts About Trulicity® (Trū-li-si-tee). It is also known as dulaglutide.

Trulicity is a prescription medicine for adults with type 2 diabetes used to improve blood sugar (glucose) and used to reduce the risk of major cardiovascular events ( problems having to do with the heart and blood vessels) such as death, heart attack, or stroke in people who have heart disease or multiple cardiovascular risk factors.

  • Trulicity is given through an injection (needle). You take it once a week by injecting it under the skin of your stomach, thigh, or upper arm. Use Trulicity together with the diet and exercise that your doctor recommends.

Warnings

Trulicity may cause tumors in the thyroid, including thyroid cancer. Watch for possible symptoms, such as a lump or swelling in the neck, trouble swallowing, hoarseness, or shortness of breath. If you have a symptom, tell your doctor.

  • Do not use Trulicity if you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC).
  • Do not use Trulicity if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
  • Do not use Trulicity if you are allergic to dulaglutide or other ingredients in Trulicity.

Ask your doctor how to recognize the serious side effects below and what to do if you think you have one:

Inflamed pancreas (pancreatitis). Stop using Trulicity and call your healthcare provider right away if you have severe pain in your stomach area (abdomen), with or without vomiting, that will not go away. You may feel the pain from your abdomen to your back.

Changes in vision. Tell your healthcare provider if you have changes in your eyesight (vision) during treatment with Trulicity.

Low blood sugar (hypoglycemia). Signs and symptoms of low blood sugar may include dizziness or light-headedness, confusion or drowsiness, headache, blurred vision, slurred speech, fast heartbeat, sweating, hunger, shakiness, feeling jittery, weakness, anxiety, irritability, or mood changes.

Serious allergic reactions. Stop using Trulicity and get medical help right away if you have any symptoms of a serious allergic reaction which may include: swelling of your face, lips, tongue or throat, problems breathing or swallowing, severe rash or itching, fainting or feeling dizzy, or very rapid heartbeat.

Acute kidney injury. In people who have kidney problems, diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration). This may cause kidney problems to get worse.

Severe stomach problems. Trulicity may cause stomach problems, which could be severe.

Common side effects

The most common side effects of Trulicity include nausea, diarrhea, vomiting, abdominal pain and decreased appetite, indigestion, and fatigue.

These are not all the possible side effects of Trulicity.

Tell your doctor if you have any side effects. You can report side effects at 1-800-FDA-1088 or www.fda.gov/medwatch.

Before using

  • Your healthcare provider should show you how to use Trulicity before you use it for the first time.
  • Before you use Trulicity, talk to your doctor about low blood sugar and how to manage it.

Review these questions with your doctor:

  • Do you have other medical conditions, including problems with your pancreas, kidneys, liver, or stomach, or have a history of diabetic retinopathy (vision problems related to diabetes)?
  • Do you take other diabetes medicines, such as insulin or sulfonylureas?
  • Do you take any other prescription medicines or over-the-counter drugs, vitamins or herbs?

Review the list below with your doctor. Trulicity may not be right for you if:

  • You are pregnant or plan to become pregnant or breastfeeding or plan to breastfeed.
  • You have type 1 diabetes.
  • You have or have had an inflamed pancreas (pancreatitis).
  • You have severe intestinal or stomach problems, such as slowed emptying or problems with digesting food.
  • You are a child under 18 years old.

How to take

  • Read the Instructions for Use that come with Trulicity.
  • Use Trulicity exactly as your doctor says.
  • Do not share your Trulicity pen, syringe or needles with another person.
  • Do not give Trulicity to other people.
  • If you take too much Trulicity, call your healthcare provider or seek medical advice promptly.

Learn more

For more information, call 1-844-TRU-INFO (1-844-878-4636) or go to www.TRULICITY.com.

This summary provides basic information about Trulicity but does not include all information known about this medicine. Read the information that comes with your prescription each time your prescription is filled. This information does not take the place of talking with your doctor. Be sure to talk to your doctor or other healthcare provider about Trulicity and how to take it. Your doctor is the best person to help you decide if Trulicity is right for you.

DG CON HL BS SEP2020

Trulicity® is a registered trademark owned or licensed by Eli Lilly and Company, its subsidiaries, or affiliates.

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