Frequently Asked Questions
Can the ‘Commercially Restricted/Cash’ option be used for patients that are covered by government programs like Medicare, Medicaid, TriCare or the VA if the patient pays cash?
No, and the encouragement to use coupons or rebate cards with patients covered by government programs violates the Federal anti-kickback statute, Section 1128B(b) of the Social Security Act (the “Act”).
Why does it matter to the government if the patient pays cash and doesn’t use their insurance benefit?
A beneficiary of a government program, regardless of how they pay for the drug is at the point of sale, may not participate in the Galderma CAREConnect offer. The government has determined that subsidies provided to beneficiaries covered by government programs, such as co-pay assistance, present all the risks of fraud and abuse associated with kickbacks, including steering beneficiaries to particular drugs; increasing costs to government programs; providing a financial advantage over competing drugs; and reducing beneficiaries’ incentives to locate and use less-expensive, equally effective products.
Can you tell me why some of your older products are not covered by the program or don’t have a cash option?
To ensure that Galderma remains committed to the future of dermatology, some tough economic decisions were made speciﬁc to a few of our older products.
If my patient gets a prescription for a Galderma product and they use a pharmacy that is in Galderma’s network, will they be guaranteed a Galderma quality product?
If your patient ﬁlls the prescription for a branded Galderma product in the GCC program and chooses to pay the relevant copay, they will receive the branded Galderma product. If the patient decides not to pay the copay and receives a generic alternative of a Galderma product, the patient will predominantly receive an authorized generic version of the Galderma product if they are ﬁlling the prescription at a Galderma-aﬃliated independent network pharmacy. Given the complexities of the market and supply chain dynamics, this may not occur in every situation.
On the Patient Savings Card, what is the difference between ‘Commercially Unrestricted’ and ‘Commercially Restricted/Cash’?
‘Commercially Unrestricted’ refers to a payment by a patient that has commercial coverage (excluding all government programs) through a pharmaceutical beneﬁt plan and a speciﬁc product has no restrictions (PA, Step Edit, NDC block, HDHP). These patients are eligible for the copay as little as $0, depending on the product. ‘Commercially Restricted/Cash’ refers to a payment by a patient with a commercial pharmaceutical beneﬁt plan that restricts or denies (PA, Step Edit, NDC Block, HDHP) access to a speciﬁc product OR to a patient that has no pharmaceutical beneﬁt plan.
Which patients qualify for the ‘Commercially Restricted/Cash’ as little as $60? Will this program remove the need for prior authorization?
For patients with a restricted commercial pharmaceutical beneﬁt plan, the pharmacist can process as ‘Commercially Restricted/Cash’ (the patient may pay as little as $60) OR the HCP and pharmacist can process the applicable restrictions, making the patient eligible for the ‘Commercially Unrestricted’ beneﬁt (the patient may pay as little as $0), clearing the edit for future reﬁlls for as little as $0. For patients without a commercial pharmaceutical beneﬁt plan, the pharmacist can process as ‘Commercially Restricted/Cash’ (the patient may pay as little as $60 at participating pharmacies). This program will not remove the need to process PAs or step edits to obtain the copay of $20.
Can this program be used at the large pharmacy chains (e.g., Walgreens, Target)?
Yes, Galderma CAREConnect Patient Savings Card may be used at any participating pharmacy located in the United States, including the independent network pharmacies. Based on reimbursement policies of some major retail chains, a patient may be asked to pay more than the quoted copay at those pharmacies. Always check the cost prior to ﬁlling prescriptions as costs may vary. The independent pharmacy chains are another option that may provide greater ease of use to your patients. Galderma is committed to ensuring that even patients with restricted access, and those that are uninsured, have access to the beneﬁts of our products at a controlled price.
Will the independent pharmacy network have these offers? Will they have any unique offers or will it be the same offer that is in the market?
Yes, the independent pharmacy program oﬀers have been harmonized to reﬂect the Galderma CAREConnect Program Patient Savings Card. Additional savings will be at the sole discretion of the pharmacy.
What are the caps on the cards?
Galderma is dedicated to the practice of dermatology and has created a generous oﬀer that will reimburse pharmacies for the full costs of the medications, less the patients’ payment, for the products listed on the Galderma CAREConnect Program Patient Savings Card.
What if I give my patient a prescription for more than one Galderma product?
This program will work well in this instance. Because the Galderma CAREConnect Program Patient Savings Card incorporates the portfolio of trusted Galderma products you prescribe, if your patient has valid prescriptions for more than one Galderma product, the savings apply to each product individually. Your patient may use the Patient Savings Card at participating pharmacies for each 30 day supply of each included Galderma product, up to 12 times annually per included Gladerma product.
Will I need to give the patient a new card each month?
No, you only need to provide your patient with one card. Your patient will keep the card and provide it to the pharmacy each month, along with the prescription and their pharmacy beneﬁt card. If your patient has valid prescriptions for more than one Galderma product, the copay expense and savings apply to each product. Your patient may use the Patient Savings Card once every 30 days for each applicable Galderma product. This oﬀer expires December 31, 2022, unless terminated earlier by Galderma.
What will happen if I call in a new Galderma prescription for a patient that is currently using the Galderma CAREConnect program?
When your patient goes to the pharmacy to pick up the prescription(s), they will provide their Galderma CAREConnect Program Patient Savings Card to the pharmacy, along with their pharmacy beneﬁt card for processing.
If a patient has a high-deductible plan, will they get their prescription for as little as $0?
Patients with commercially unrestricted access to their prescription should have as little as a $0 copay. The patient will need to present the prescription and the Galderma CAREConnect Program Patient Savings Card with their pharmacy beneﬁt card to the pharmacist. If the patient has restrictions for their prescription, or has no commercial pharmaceutical beneﬁt, the prescription will be as little as $60. The HCP and pharmacist can process the applicable restrictions, making the patient eligible for the ‘Commercially Unrestricted’ beneﬁt (the patient may pay as little as a $0 copay), and clearing the edit for future reﬁlls.
What if my preferred pharmacy doesn’t redeem the card?
Galderma doesn’t select individual patient pharmacy providers. A patient or health care provider may have the opportunity to choose from a variety of pharmacy providers.