Olumiant Together

Supporting You Every Step of The Way

Olumiant Together is a support program that gives you access to the Companion in Care^TM team—a group of people available to help you with personalized assistance, RA resources, and support throughout your treatment.

Olumiant Together can provide you with:

Personalized support along your treatment journey
Assistance in confirming your insurance coverage
Savings options for commercially insured patients
Help in coordinating with your specialty pharmacy to receive your medication

If you do not qualify for a savings card, you can still enroll in Olumiant Together by calling 1-844-OLUMIANT (1-844-658-6426).

To get your savings card,^* we need your HIPAA authorization to work on your behalf to ensure you’re paying as little as $5 or $25 a month.

As a reminder, HIPAA is the Health Insurance Portability and Accountability Act. It provides data privacy and security to protect your medical information.

^*Offer good until 12/31/2020. $5 monthly offer subject to wholesale acquisition cost plus usual and customary pharmacy charges and a separate maximum annual cap of $12,000. $25 monthly offer subject to monthly and annual cap of wholesale acquisition cost plus usual and customary pharmacy charges. This offer is not available for patients without commercial insurance coverage or those whose prescription claims are eligible to be reimbursed, in whole or in part, by Medicare Part D, Medicaid, TRICARE or any other state or federal program. Offer void where prohibited by law and subject to change or discontinue without notice. Card activation is required. Subject to additional terms and conditions, which can be found here.

Save on Olumiant

You might be able to save on Olumiant even if your commercial insurance doesn’t cover the cost of your treatment.^*

Explore savings offers

PURPOSE and SAFETY SUMMARY Warning: Serious Infections, Cancers and Blood Clots

Warning: Serious Infections, Cancers and Blood Clots

PURPOSE AND SAFETY SUMMARY

Important Facts About Olumiant^® (O-loo-mē·ant). It is also known as baricitinib.

Olumiant is a prescription medicine used to treat adults with moderately to severely active rheumatoid arthritis (RA) who have tried at least one other medicine called a tumor necrosis factor (TNF) antagonist that did not work well enough or could not be tolerated. The medicine comes in a tablet and is taken orally.

WARNINGS

Olumiant may cause serious side effects. Some people who have taken Olumiant have had:

Serious infections, including tuberculosis (TB), shingles, and others caused by bacteria, fungi, or viruses. Some people have died from these infections. Olumiant can make you more likely to get infections or make them worse. Your doctor should test for TB before starting Olumiant and watch for TB symptoms during treatment. You should not start Olumiant if you have any kind of infection unless your doctor tells you it is okay. While taking Olumiant, tell your doctor right away if you have symptoms of an infection, such as:
- fever, sweating, or chills
- muscle aches
- cough
- shortness of breath
- blood in phlegm
- weight loss
- warm, red, or painful skin or sores on your body
- diarrhea or stomach pain
- burning with urination or urinating more often than normal
- feeling tired
Cancer and immune system problems. Olumiant may increase your risk of lymphoma and other cancers, including skin cancers.
Blood clots in the veins of your legs or lungs. This may be life-threatening and cause death. While taking Olumiant, tell your doctor right away if you have any signs and symptoms of blood clots, including swelling, pain or tenderness in the leg, sudden chest pain, or shortness of breath.
Tears in the stomach or intestines. This happens most often in people who also take nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or methotrexate. While taking Olumiant, tell your doctor right away if you have fever and stomach-area pain that does not go away, and a change in bowel habits.
Changes in laboratory test results. Your doctor should do blood tests to check your white and red blood cells before and while you are taking Olumiant. Your doctor should also check certain liver tests. You should not take Olumiant if your blood cell counts are too low or your liver tests are too high. If your results change, your doctor may pause your treatment with Olumiant. Your doctor should also check your cholesterol approximately 12 weeks after you start this medicine and as needed after that.

COMMON SIDE EFFECTS

The most common side effects of Olumiant include:

upper respiratory tract infections, such as a cold or sinus infections
nausea

cold sores
shingles

These are not all the possible side effects of Olumiant. Tell your doctor if you have any side effects. You can report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

BEFORE USING

Before you use Olumiant, tell your doctor if you:

Are being treated for an infection, have an infection that won’t go away or keeps coming back, or think you have symptoms of an infection.
Have TB or have been in close contact with someone with TB.
Have had hepatitis B or C, cancer, or blood clots in the veins of your legs or lungs.
Live, have lived, or have visited parts of the country that increase your risk of fungal infections. These may include the Ohio and Mississippi River valleys and the Southwest. Ask your doctor if you do not know if you have lived in an area where these infections are common.
Have other medical conditions, including kidney or liver problems, low blood cell counts, diabetes, lung disease, HIV, or a weak immune system.
Have any stomach-area pain or have been diagnosed with inflammation in the large intestine or ulcers in your stomach or intestines.
Have recently received or plan to receive a vaccine. People taking Olumiant should not receive live vaccines.
Are pregnant or plan to become pregnant, or are breastfeeding or plan to breastfeed. You should not take Olumiant and breastfeed.
Are taking other medicines, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Especially tell your doctor, if you take a medicine called probenecid or any other medicines to treat rheumatoid arthritis. For example, you should not take any of the following medicines while taking Olumiant since this may increase your risk of infection:
- tocilizumab (Actemra^®)
- etanercept (Enbrel^®)
- adalimumab (Humira^®)
- infliximab (Remicade^®)
- rituximab (Rituxan^®)
- abatacept (Orencia^®)
- anakinra (Kineret^®)
- certolizumab pegol (Cimzia^®)
- golimumab (Simponi^®)
- tofacitinib (Xeljanz^®/Xeljanz XR^®)
- sarilumab (Kevzara^®)
- azathioprine or cyclosporine
Are under age 18. It is not known if Olumiant is safe and effective in children.

HOW TO TAKE

Take Olumiant exactly as your doctor says.
Take Olumiant once a day with or without food.

LEARN MORE

For more information, call 1-800-545-5979.

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

Please see full Prescribing Information, including Warnings on Serious Infections, Cancers, and Blood Clots, and Medication Guide.

Olumiant^® is a registered trademark owned or licensed by Eli Lilly and Company, its subsidiaries, or affiliates. All other product names and trademarks are the property of their respective trademark owners. ©Lilly USA, LLC 2019.

BA CON BS 08JAN2019

Terms and Conditions:

$5 monthly offer subject to wholesale acquisition cost plus usual and customary pharmacy charges and a separate maximum annual cap of $12,000. $25 monthly offer subject to a monthly and annual cap of wholesale acquisition cost plus usual and customary pharmacy charges. If you meet program eligibility requirements, have commercial insurance, and your insurance provider covers Olumiant, you are eligible to pay $5 monthly. If you meet program eligibility requirements, have commercial insurance, and your insurance provider denies coverage and a PA, and then an appeal is submitted for Olumiant, you are eligible to pay $25 monthly. To continue to participate in the $25 monthly program, patients who qualify are required to submit and have an appeal decision within 6 months post program initiation, to verify coverage status and potential eligibility for the $5 monthly program. Eligible patients may be able to use the $5 and $25 monthly offers until 12/31/2020 provided they continue to meet program criteria.

^*By using the Olumiant Savings Card (“Card”), you attest that you meet the eligibility criteria and will comply with the Terms and Conditions described below:

Offer void where prohibited by law. This offer is invalid for patients without commercial drug coverage or those whose prescription claims 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. If you live in Massachusetts, the Card expires on the earlier of: (i) the expiration date of this Card (12/31/2020); (ii) the date an AB-rated generic equivalent for Olumiant becomes available; or (iii) June 30, 2019, absent a change in Massachusetts state law. If you live in California, the Card expires on the earlier of: (i) the expiration date of this Card (12/31/2020) or (ii) the date an FDA-approved therapeutically equivalent for Olumiant or over-the-counter product with the same active ingredients becomes 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, incentive, or similar offer involving Olumiant. 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 12/31/2020.