WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients.

EMSAM® (selegiline transdermal system) is not for children less than 12 years of age as it may cause a severe increase in blood pressure

What is the EMSAM® (selegiline transdermal system) co-pay savings offer?
You pay only the first $20 of your co-pay for each of your prescriptions (up to 12 prescriptions). Mylan Specialty L.P. will pay up to $500 per month of your remaining co-pay. That's a maximum savings of up to $6,000 annually!
You can use it again and again.
If you are eligible for the EMSAM Savings Card program, you can reuse the card for each prescription (up to 12 prescriptions) through December 31, 2018.
See if you're eligible.
Fill out the following form. Certain restrictions apply. See below for Terms and Conditions. If you qualify, you are just a few minutes away from downloading your card.


Getting Started
It will take just a few minutes to fill in your information to download your card.

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* Are you:

License number is required to apply for the EMSAM co-pay card for those who practice in VT or MA.
We are sorry. This offer is not available for government funded insurance programs. If you have questions about eligibility or need help determining eligibility, please call 1-800-796-9526 for assistance.
We are sorry. This offer is not available for cash paying customers. If you have questions about eligibility or need help determining eligibility, please call 1-800-796-9526 for assistance.
EMSAM® (selegiline transdermal system) Savings Card Terms and Conditions

This SAVINGS card can be used to reduce the amount of your out-of-pocket expense for EMSAM® Transdermal System up to a maximum of $500 per month after your pay the first $20 for a 30-day supply. No other purchase is necessary. This offer can be used an unlimited number of times through December 31, 2018. Valid prescription with Prescriber ID# required.

Eligibility Requirements: This SAVINGS card can be redeemed only by patients or patient guardians who are 18 years of age or older who are a resident of the United States and its territories. Patients must have commercial insurance. Not valid for uninsured patients (except for commercially insured patients without coverage for EMSAM® Transdermal System) 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 EMSAM® Transdermal System is covered by such government program); if the patient is Medicare eligible and enrolled in an employer-sponsored health plan or prescription benefit program for retirees; or if the patient's insurance plan is paying the entire cost of this prescription. Void outside the US and its territories or where prohibited by law, taxed, or restricted. This program is valid in Massachusetts through June 30, 2019, unless otherwise amended or extended by Massachusetts.

This SAVINGS card is not health insurance. The SAVINGS card is not transferable and the amount of the benefit cannot exceed the patient's out‑of‑pocket expenses. Cannot be combined with any other rebate/coupon, free trial, or similar offer for the specified prescription. Mylan Specialty reserves the right to amend or end this program at any time without notice. Data related to your redemption with this SAVINGS card may be collected, analyzed, and shared with Mylan Specialty for market research and other purposes related to assessing coupon programs. Data shared with Mylan Specialty will be aggregated and de‑identified, meaning it will be combined with data related to other SAVINGS card redemptions and will not identify you. The SAVINGS card is not redeemable for cash.

Patient Instructions: Present your SAVINGS card and prescription drug insurance card, along with a valid prescription for the EMSAM®Transdermal System. By using this SAVINGS card, you acknowledge that you currently meet the eligibility criteria 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 acceptance of this offer must be consistent with the terms of any drug benefit provided by your health insurer. You agree to report the use of this SAVINGS card to your insurer if required.

Pharmacist Instructions: When you use this SAVINGS card, you are certifying that you have received this SAVINGS card from 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 the terms hereof. 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
• Primary coverage must exist. Input SAVINGS card information as secondary coverage and transmit using the COB segment of the NCPDP transaction. Applicable discounts will be displayed in the transaction response.
• Acceptance of this SAVINGS card and your submission of claims for the EMSAM® program are subject to the Mylan Specialty SAVINGS card Terms and Conditions posted http://www.emsam.com/copay.
• Acceptance of this SAVINGS card and your submission of claims for the EMSAM® 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 EMSAM® program at 800-657-7613 (8:00 AM-8:00 PM EST, Monday-Friday).

INDICATION

What is EMSAM Transdermal System?
EMSAM Transdermal System is a skin patch used to treat major depressive disorder.

IMPORTANT SAFETY INFORMATION

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

• Antidepressants may increase suicidal thoughts or actions in children, teenagers and young adults.

• Depression and other serious mental illnesses are the most important cause of suicidal thoughts and actions. Pay close attention to any changes, especially sudden changes, in mood, behaviors, thoughts or feelings. This is very important when an antidepressant is started or when the dose is changed. Call a health care professional right away to report any new or sudden changes in mood, behavior, thoughts or feelings. Keep follow-up visits with your health care professional, as scheduled, and call if you have concerns about symptoms.

• EMSAM® (selegiline transdermal system) is not for children less than 12 years of age as it may cause a severe decrease in blood pressure.

What is the most important information I should know about EMSAM?
• Antidepressants may increase suicidal thoughts or actions in children, teenagers and young adults.
Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions.
    - Pay close attention to any changes, especially sudden changes, in mood, behaviors, thoughts or feelings. This is very important when an antidepressant is started or when the dose is changed.
    - Call a health care professional right away to report any new or sudden changes in mood, behavior, thoughts or feelings.
    - Keep follow-up visits with your health care professional, as scheduled, and call if you have concerns about symptoms.
EMSAM Transdermal System is not for children less than 12 years of age as it may cause a severe increase in blood pressure.

Call a health care professional right away if you, or someone you care for, have any of the following symptoms, especially if they are new, worse or worry you:

• thoughts about suicide or dying
• attempts to commit suicide
• new or worse depression
• new or worse anxiety
• feeling agitated, restless, angry or irritable
• panic attacks
• trouble sleeping
• new or worse irritability
• acting aggressive, being angry or violent
• acting on dangerous impulses
• an extreme increase in activity or talking (mania)
• other unusual changes in behavior or mood

Who should not use EMSAM?

Using EMSAM with certain antidepressants and certain pain, cold and cough symptom medicines may cause a potentially life-threatening problem called serotonin syndrome (See "What are the possible side effects of EMSAM?").

Do not use EMSAM if you:

take certain medicines including: selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, sertraline, or paroxetine; serotonin and norepinephrine reuptake inhibitors (SNRI) such as venlafaxine or duloxetine; clomipramine or imipramine (tricyclic antidepressants); meperidine, tramadol, methadone, pentazocine, propoxyphene (opioid medicines); dextromethorphan; or carbamazepine
are less than 12 years of age
have a tumor on your adrenal gland called a pheochromocytoma

Ask your health care professional or pharmacist if you are not sure if you take these medicines.

What should I tell my doctor before starting EMSAM Transdermal System?

Tell your health care professional if you:
• have high blood pressure
• have or had mania or bipolar disorder (manic depression)
• have or had seizures or convulsions
• drink alcohol
• have any other medical conditions
• are or intend to become pregnant
• are breastfeeding or intend to breastfeed

Tell your doctor about all medicines you take, including prescription and non-prescription medicines, vitamins and herbal supplements. EMSAM and some medicines may interact with each other, may not work as well or may cause serious side effects when taken together.

In particular, tell your health care professional if you take:

• other medicines to treat depression (antidepressants) including other MAOI medicines
• decongestant medicines to treat cold or cough symptoms
• over-the-counter diet pills or herbal weight-loss products
• any herbal or dietary supplement that contains tyramine and/or medicines called stimulants or uppers (amphetamines)
• buspirone, an anxiety medicine

Some of these medicines need to be stopped for at least 1 week before you can start using EMSAM and for 2 weeks after you stop using EMSAM. Ask your health care professional or pharmacist if you are not sure if you take these medicines. Know the medicines you take. Keep a list of them to show your health care professional or pharmacist when you get a new medicine.

What should I avoid while using EMSAM?

• Avoid exposing the EMSAM application site to external sources of direct heat, such as heating pads or electric blankets, heat lamps, saunas, hot tubs, heated water beds and prolonged direct sunlight.
Do not eat foods or drink beverages that contain high amounts of tyramine (e.g. aged and fermented meats, broad bean pods, aged cheese, all tap beers, most soybean products and over-the-counter supplements containing tyramine) while using EMSAM 9 mg or EMSAM 12 mg or for 2 weeks after you stop using EMSAM 9 mg or EMSAM 12 mg. You do not have to make any diet changes when you use EMSAM 6 mg. Ask your health care professional or see the Medication Guide for a complete list of foods and drinks that must be avoided.
• Do not drive, operate heavy machinery or do other dangerous activities until you know how EMSAM affects you.
• You should not drink alcohol while using EMSAM.

What are the possible side effects of EMSAM? EMSAM may cause serious side effects, including:

See "What is the most important information I should know about EMSAM?"
Serotonin syndrome. A potentially life-threatening problem called serotonin syndrome can happen when you use EMSAM while you take certain medicines called MAOIs. Symptoms of serotonin syndrome include: agitation; seeing things that are not there (hallucinations); confusion; coma; rapid pulse; low blood pressure; dizziness; sweating; flushing; fever; seizures; tremors; stiff muscles; muscle twitching; become unstable; nausea; vomiting; and diarrhea.
•   If you suddenly have these symptoms, go to the nearest hospital emergency room right away.
A sudden, severe increase in blood pressure (hypertensive crisis). A hypertensive crisis can happen when you eat certain foods and drink certain beverages while you use EMSAM. sudden, severe increase in blood pressure (hypertensive crisis). A hypertensive crisis can happen when you eat certain foods and drink certain beverages while you use EMSAM. "What should I avoid while using EMSAM?
A hypertensive crisis can also happen if you use EMSAM with certain other medicines. See "Who should not use EMSAM?"
• Symptoms of a hypertensive crisis include: sudden, severe headache; nausea; vomiting; stiff or sore neck; a fast heartbeat (palpitations) or a change in the way your heart beats; excessive sweating sometimes with fever or cold, clammy skin; the pupils in your eyes increase in size; light bothers your eyes; fast or slow heart beat with chest pain; and bleeding in your brain. If you suddenly have these symptoms, go to the nearest hospital emergency room right away.
Mania or hypomania (manic episodes) in people who have a history of mania. Symptoms of manic episodes include: greatly increased energy; severe problems sleeping; racing thoughts; reckless behavior; excessive happiness or irritability; talking more or faster than usual; and unusually grand ideas

Common side effects in people who use EMSAM include:

• a skin reaction where the patch is placed. You may see mild redness at the site when a patch is removed. This redness should go away within several hours after removing the patch. If irritation or itching continues, tell your health care professional.
• headache
• diarrhea
• indigestion
• trouble sleeping (insomnia)
• dry mouth
• rash
• sore throat
• sinus infection

Tell your health care professional if you have any side effect that bothers you or does not go away. These are not all the side effects of EMSAM. For more information, ask your health care professional or pharmacist.

Please see full Prescribing Information, including Boxed Warning and Medication Guide.

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