Eligibility Criteria, Terms and Conditions for the
Siliq Solutions Instant Savings Program:

  • These offers are valid for commercially insured patients being treated with SILIQ (brodalumab) injection, for subcutaneous use, for an approved indication, and are good for use only with a SILIQ prescription at the time the prescription is filled.
  • If a commercially insured patient’s insurance covers SILIQ, he or she may pay as little as $25 per month for SILIQ, up to a maximum savings limit of $20,000 for 12 months from the patient's first eligible date of program participation. Patient is responsible for all additional costs and expenses after savings program limit is reached.
  • Participation in the SILIQ $50 per month program, for eligible patients whose commercial insurance does not cover SILIQ, will expire 12 months from program initiation. During this time, health care providers and patients are encouraged to work together to submit appeals to the patient's health plan in order to obtain coverage to ensure continued treatment with SILIQ.
  • Uninsured patients are not eligible to participate in the instant savings program.
  • These offers are not valid for any person eligible for reimbursement of prescriptions, in whole or in part, by any federal, state or other governmental programs, including but not limited to Medicare (including Medicare Advantage and Part A, B and D Plans), Medicaid, TRICARE, Veterans Administration or Department of Defense health coverage, CHAMPUS, the Puerto Rico Government Health Insurance Plan, or any other federal or state health care programs.
  • Eligible patients may not seek reimbursement for all or any part of the benefit received through these offers and are responsible for making any required reports of use of these offers to any insurer or other third party who pays any part of the prescription filled.
  • These offers are good only in the USA, including Puerto Rico, at pharmacies enrolled in the SILIQ REMS Program. These offers are not valid in states where otherwise prohibited, taxed, or otherwise restricted.
  • Patient must be 18 years of age or older to redeem these offers for him or herself or for a minor.
  • Each card is valid for up to 26 injections, or 13 new prescriptions of SILIQ.
  • This card is only good for use with SILIQ. No other purchase necessary.
  • These offers and the card are not health insurance.
  • This card is not transferable. The selling, purchasing, trading, or counterfeiting of this card is prohibited by law. Void if reproduced.
  • These offers are not valid with other offers. This card has no cash value. No cash back.
  • Ortho Dermatologics’ affiliated entities reserve the right to rescind, revoke, terminate, or amend these offers at any time, without notice.
  • The patient understands and agrees to comply with the terms and conditions of these offers.
  • Offers expire December 31, 2022.

Indication and Important Safety Information for SILIQ (brodalumab) Injection

What is SILIQ?
SILIQ injection is a prescription medicine used to treat adults with moderate to severe plaque psoriasis:

It is not known if SILIQ is safe and effective in children.

What is the most important information I should know about SILIQ?

Suicidal thoughts or behavior: Some patients taking SILIQ have had suicidal thoughts or ended their own lives. This risk is higher if you have a history of suicidal thoughts or depression. It is not known if SILIQ causes these thoughts or actions. Get medical help right away if you or a family member notices that you have any of the following symptoms:

Your healthcare provider will give you a SILIQ patient/wallet card about symptoms that need medical attention right away. Carry the card with you during treatment with SILIQ and show it to all of your healthcare providers.

Serious Infections: SILIQ may lower the ability of your immune system to fight infections and may increase your risk of infections.