Sign Up to Save on YUPELRI

NOT ACTUAL PATIENTS

With the YUPELRI Savings Card, eligible patients with private/commercial insurance may pay as little as $0 for a 30-day fill, up to 12 fills per calendar year, of YUPELRI (revefenacin) inhalation solution.*

*No other purchase is necessary; conditions and limitations apply. Please see full terms and conditions. This offer is not valid for patients covered by Medicare, Medicaid, or any other federal- or state-funded healthcare program or where prohibited by law. Viatris Specialty LLC reserves the right to amend or end this program at any time without notice.

Fill out the form below to get a YUPELRI Savings Card.

  • I do not have insurance from any Federal Healthcare Program (including Medicare, Medicaid, TRICARE, or any other state or federal medical pharmaceutical benefit program or pharmaceutical assistance program)
  • I do not receive health insurance through the military)
  • I have commercial insurance coverage)
  • I am 18 years of age or older)
  • I am a resident of the United States)
  • I agree to the Terms and Conditions
*Please select the checkbox before proceeding.

Patient Information

*Please enter first name. *Please enter valid first name.
*Please enter last name. *Please enter valid last name.
*Please enter email address. *Please enter a valid email address.
*Please enter your birth date. *Please enter a valid Birth Date.
*Please enter your phone number. *Please enter a valid Phone Number.
*Please enter your Zip Code. *Please enter a valid Zip Code.

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By signing up, you authorize Viatris Inc. and trusted parties acting on its behalf, to send you the YUPELRI materials you requested and other commercial communications from Viatris Inc. By enrolling, you confirm that you are a resident of the United States and at least 18 years of age.

Viatris Inc. understands that your personal data is private. To learn about how Viatris Inc. uses your personal data, please view our Privacy Notice.

We do not sell your email address and you may opt out at any time. Deciding not to receive email communications will in no way affect eligibility for the Savings Card program.

YUPELRI® Savings Card Terms and Conditions

With this Savings Card, you may pay as little as $0 for each monthly fill of YUPELRI, while this program remains in effect. This Savings Card may be used to reduce the amount of your out-of-pocket costs for YUPELRI up to the full amount of your out-of-pocket cost per 30-day prescription, subject to a maximum aggregate amount while this program remains in effect. Whether you are eligible to receive the maximum aggregate amount is determined by the type of commercial insurance plan coverage you have, and savings may vary depending upon your out-of-pocket costs associated with the prescription. This offer can be used for up to a total of 12 30-day fills per calendar year while this program remains in effect. No other purchase is necessary. Valid prescription with Prescriber ID# is required. Viatris Specialty LLC reserves the right to amend or end this program at any time without notice.

Eligibility Requirements: This Savings Card can be redeemed only by patients or patient guardians who are 18 years of age or older and who are residents of the United States and its territories. Patients must have commercial insurance. This program is not valid for uninsured patients (but may be used by commercially insured patients without coverage for YUPELRI) and patients who are covered by any state or federally funded healthcare program, including but not limited to any state pharmaceutical assistance program, Medicare (Part D or otherwise), Medicaid, Medigap, VA or DOD, or TRICARE (regardless of whether YUPELRI is covered by such government program); not valid if the patient is Medicare-eligible and enrolled in an employer-sponsored health plan or prescription benefit program for retirees; and not valid if the patient's insurance plan is paying the entire cost of this prescription. This program is void outside the US and its territories or where prohibited by law, taxed, or restricted. This program may not be available in all states.

This Savings Card is not health insurance. This Savings Card is not transferable, and the amount of the savings cannot exceed the patient's out-of-pocket costs. This Savings Card cannot be combined with any other rebate/coupon, cash discount card, free trial, or similar offer for the specified prescription. This Savings Card is not redeemable for cash. This Savings Card is not valid if the patient's commercial health insurance plan or pharmacy benefit manager uses a copay adjustment program (often termed "maximizer" or "accumulator" program) that restricts any form of copay assistance from being counted toward the patient's cost-sharing limits.

NOTICE: Data related to your use of this Savings Card may be collected, analyzed and shared with Viatris Specialty LLC for market research and other purposes related to assessing its savings card programs. Data shared with Viatris Specialty LLC will be aggregated and de-identified, meaning it will be combined with data related to other savings card redemptions and will not identify you.

Patient Instructions: By using this Savings Card, you hereby accept and agree to abide by these terms and conditions. Further, you acknowledge and agree that you currently meet the eligibility criteria and other requirements each and every time you use this Savings Card and that you understand and will comply with the following additional terms and conditions:

  • You have not submitted and will not submit a claim for reimbursement under any federal, state or other governmental programs for this prescription.
  • Your use of the Savings Card must be consistent with the terms of any drug benefit provided by your commercial health insurer, health plan, or private third-party payer. You agree to report the use of this Savings Card to your commercial insurer if required.
  • Where required, a Savings Card and prescription drug insurance card, along with a valid prescription for YUPELRI, must be presented to your pharmacist.
  • Should you begin receiving prescription benefits from any government funded program, you will withdraw from this Savings Card program.
  • For questions regarding patient eligibility or other program information or issues, call the LoyaltyScript® for YUPELRI Savings Card program at 866-255-9018 (8:00 AM-8:00 PM EST, Monday-Friday)

Pharmacist instructions: When you accept this Savings Card, you are certifying that you have received this Savings Card from an eligible patient; you have received a valid prescription for YUPELRI for an eligible patient; you have dispensed the product as indicated; you have not submitted and will not submit a claim for reimbursement under any federal, state or other governmental programs for this prescription; and you will otherwise comply with these terms and all applicable terms and conditions. You further certify that your participation in this program is consistent with all applicable state laws and any obligations, contractual or otherwise, that you have as a pharmacy provider, and that you will report the use of this Savings Card to the patient's insurer if required.

  • Submit transaction to McKesson Corporation using BIN #610524.
  • For commercially insured patients, input this Savings Card information as secondary coverage and transmit using the COB segment of the NCPDP transaction.
    Applicable patient savings will be displayed in the transaction response. Cash Discount Cards are not valid as primary insurance under this offer.
  • Acceptance of this Savings Card and your submission of claims for the YUPELRI Savings Card program are subject to the Savings Card Terms and Conditions posted at www.yupelri.com/coverage-and-savings/yupelri-patient-savings-card.
  • Acceptance of this Savings Card and your submission of claims for the YUPELRI Savings Card program are subject to the LoyaltyScript® program Terms and Conditions posted at www.mckesson.com/mprstnc.
  • For questions regarding setup, claim transmission, patient eligibility or other issues, call the LoyaltyScript® for YUPELRI Savings Card program at 866-255-9018 (8:00 AM-8:00 PM EST, Monday-Friday)

Stay informed about YUPELRI

Receive important updates about YUPELRI® (revefenacin) inhalation solution.
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Important safety information

What is YUPELRI®?
  • YUPELRI is a prescription medicine used to treat chronic obstructive pulmonary disease (COPD), a long-term (chronic) lung disease that includes chronic bronchitis, emphysema, or both.
  • It is an anticholinergic medicine which helps the muscles around the airway in your lungs stay relaxed to prevent symptoms such as wheezing, cough, chest tightness, and shortness of breath.
  • It is used long-term as 1 vial of YUPELRI, 1 time each day inhaled through your nebulizer to improve symptoms of COPD for better breathing.
Who should not use YUPELRI?
  • Do not use YUPELRI if you have sudden breathing problems. Always have a rescue inhaler with you.
  • Do not use YUPELRI if you have had an allergic reaction to revefenacin, or any of the other ingredients in YUPELRI (sodium chloride, citric acid, sodium citrate).
  • Do not use in children. It is not known if YUPELRI is safe and effective in children.

Before using YUPELRI, tell your healthcare provider about all your medical conditions, including if you:

  • have eye problems such as glaucoma. YUPELRI may make your glaucoma worse.
  • have prostate or bladder problems, or problems passing urine. YUPELRI may make these problems worse.
  • have liver problems.
  • are allergic to any of the ingredients in YUPELRI, or any other medicines.
  • are pregnant or planning to become pregnant. It is not known if YUPELRI may harm your unborn baby.
  • are breastfeeding. It is not known if the medicine in YUPELRI passes into your breast milk and if it can harm your baby.

Tell your healthcare provider about all the medicines you take including prescription and over-the-counter medicines, vitamins, and herbal supplements. YUPELRI and certain other medicines may interact with each other. This may cause serious side effects.

Especially tell your healthcare provider if you take:

  • Other anticholinergics (including tiotropium, ipratropium, aclidinium, umeclidinium, glycopyrrolate)
  • Atropine

Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist each time you get a new medicine.

What are the possible side effects with YUPELRI?

YUPELRI can cause serious side effects, including:

  • Sudden breathing problems immediately after inhaling your medicine. If you have sudden breathing problems immediately after inhaling your medicine, stop using YUPELRI and call your healthcare provider right away.
  • New or worsened eye problems including acute narrow-angle glaucoma. Acute narrow-angle glaucoma can cause permanent loss of vision if not treated. Symptoms may include:
    • Red eyes
    • Blurred vision
    • Seeing halos or bright colors around lights
    • Eye pain or discomfort
    • Nausea or vomiting
  • Urinary retention. People who take YUPELRI may develop new or worse urinary retention. Symptoms of urinary retention may include:
    • difficulty urinating
    • urinating frequently
    • urination in a weak stream or drips
    • painful urination

If you have any of these symptoms, call your healthcare provider right away before taking another dose.

  • Serious allergic reactions. Call your healthcare provider or get emergency medical care if you get any of the following symptoms of a serious allergic reaction:
    • rash
    • hives
    • severe itching
    • swelling of your face, mouth, and tongue
    • difficulty breathing or swallowing

If you have any of these symptoms, stop taking YUPELRI, and call your healthcare provider right away before taking another dose.

Common side effects of YUPELRI include:

  • Cough
  • Runny nose
  • Upper respiratory tract infection
  • Headache
  • Back pain

Tell your healthcare provider if you get any side effects that bother you or that do not go away. These are not all the possible side effects with YUPELRI. Ask your healthcare provider or pharmacist for more information. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

How should I use YUPELRI?

Read the step-by-step instructions for using YUPELRI in the full Instructions For Use

  • YUPELRI is only for use with a nebulizer.
  • Do not use YUPELRI more often than prescribed.
  • Do not mix YUPELRI with other medicines in your nebulizer.
  • Do not use other medicines that contain an anticholinergic for any reason.
  • Do not stop using YUPELRI, even if you are feeling better, unless your healthcare provider tells you to because your symptoms might get worse.
  • Call your healthcare provider or get emergency medical care right away if
    • your breathing problems get worse.
    • you need to use your rescue inhaler medicine more often than usual.
    • your rescue inhaler medicine does not relieve your symptoms.

This summary does not include all the information about YUPELRI and is not meant to take the place of a discussion with your healthcare provider about your treatment.

Please see the Full Prescribing Information. For additional information, please contact us at 1-800-395-3376.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.