Take advantage of the XYOSTED co-pay assistance program!

This program provides a maximum benefit up to $125 per 28-day supply and up to $375 for a 84-day supply. Eligible patients* may pay as low as $15 co-pay for each prescription filled. This card is valid for up to 13 fills.

In order to be able to better assist you with the insurance claims process and help you pay as little as possible, we will ask you for your Health Insurance Portability and Accountability Act (HIPAA) authorization. As a reminder, HIPAA is the law that provides data privacy and security to protect your health information. We believe that by taking a little extra time now to provide HIPAA authorization, we can help you pay as little as possible for your XYOSTED medication. You are not obligated to provide HIPAA authorization, however, our ability to assist you will be limited without this authorization.

1. Activate your card
2. Present this card with a valid prescription to your pharmacist.
3. You will receive co-pay assistance for up to $125 per 28-day prescription.
4. If you have any questions, please feel free to call 866-255-8984.

You recognize and agree that when submitting your personally identifying information, while Antares has safeguards in place to prevent unauthorized access or interception, there is no absolute guarantee of security. In the unlikely event of an interception or unauthorized access despite our efforts, Antares shall not be responsible for such interceptions or unauthorized access, or any direct, indirect, special, incidental, or consequential damages (including lost profits) suffered by a user, even if Antares has previously been advised of the possibility of such damages, Antares does not warrant, either expressly or implied, that the information provided by any customer shall be free from interception or unauthorized access, and does not provide any implied warranties of merchantability and fitness for a particular purpose.

*Eligibility restrictions: XYOSTED must be covered without restriction by patient's commercial insurance. Offer not valid for prescriptions reimbursed under any federal or state healthcare program, including Medicare, Medicaid, or any state medical assistance programs. Offer void where prohibited by law, taxed, or restricted. Offer only valid in the USA. To qualify for the enhanced co-pay program ("Enhanced Co-Pay Program"), patient's co-pay for a 28-day supply of XYOSTED must be greater than $466 before any offers or assistance are applied. Co-pays for supplies greater than 28 days must maintain the same ratio in order to qualify for the Enhanced Co-Pay Program (for 56 day supply, co-pay must be greater than $932, for 84 day supply, co-pay must be greater than $1398). For patients who qualify for the Enhanced Co-Pay Program, co-pay will be reduced to $175 for each 28-day prescription filled up to a maximum of three 28-day prescriptions. The Enhanced Co-Pay Program is available from January 1, 2024 through March 31, 2024. Patients not eligible for the Enhanced Co-Pay Program may receive a maximum benefit up to $125 for each prescription filled assuming all other eligibility restrictions for the co-pay program are met. Halozyme reserves the right to rescind, revoke, or amend this offer at any time without notice. By using this co-pay card, you demonstrate that you understand and agree to comply with the terms and conditions of this offer as put forth on this co-pay assistance card.

Valid in the US only.

Antares Pharma, Inc. a Halozyme Company, reserves the right to rescind, revoke, or amend this offer at any time without notice.
By using this co-pay card, you demonstrate that you understand and agree to comply with the terms and conditions of this offer as put forth on this co-pay assistance card.

The information on this website is not intended or recommended as a substitute for medical advice, diagnosis or treatment. Always seek the advice of your own licensed physician or other qualified health care provider regarding any medical questions or conditions.

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. For more information, go to www.XYOSTED.com or call 1-844-XYOSTED (1-844-996-7833).