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Eligibility Requirements »

In order to activate your $0* Copay Card, you must meet the eligibility requirements:

Are you currently a resident of the United States or Puerto Rico?

Are your prescriptions paid for in part or in full under any state or federally funded program? Such programs include, but are not limited to, Medicare or Medicaid, Medigap, VA, DOD, or TriCare.

* Certain restrictions apply. For eligible patients with private health insurance, this card may cover the entire insurance copay or up to $300 of the cash price if you are not insured. For specific eligibility requirements and program restrictions, click here or call 1-888-203-1104. Each card is valid for up to 6 prescription fills for Taclonex® Topical Suspension.

*Card ID#

*Patient First Name

*Patient Last Name

*Street Address

Street Address (cont.)

*City

*State

*Zip Code

*Patient Date of Birth

*Phone Number

*Preferred Method of Contact

Here is how LEO Pharma may use your personal information. We only use personal information for the reasons it was provided. We may disclose your personal information to third party service providers, but only the information needed for each service. We will notify you before we use or disclose your personal information for any other reason and you will have an opportunity to opt-out. We use commercially reasonable measures to protect personal information, but we assume no liability for its loss, misuse or unauthorized disclosure. If our business is sold, we will require the purchaser to honor our Privacy Policy. You may change or remove your personal information by calling 1-888-203-1104. For a copy of the LEO Pharma Privacy Policy click on the Privacy Link below. The information you provide, as well as the information obtained about you from the pharmacy, will be shared with the manufacturer and any companies working with the manufacturer.

Do you agree to the Taclonex® Copay Card Terms and Conditions and consent to use and disclosure of your personal information under the LEO Pharma Privacy Policy for the purpose of activating the Copay Card and providing administrative updates relating to the Copay Card?

Taclonex® is offering a free and confidential support program called QualityCare to help both patients and caregivers:

  • Connect with helpful specialists for assistance
  • Learn more about plaque psoriasis
  • Watch patient videos

Do you agree and consent to the use and disclosure of your personal information under the
LEO Pharma Privacy Policy for the purpose of enrolling in the QualityCare program? As part of the QualityCare program, LEO may use your personal information to contact you via phone, e-mail, or mail.

We would like to use your personal information to contact you to provide marketing information on LEO Pharma products, services, and programs, or to promote disease awareness. This marketing information could be sent to you via e-mail, telephone, or mail. Do you consent to the use and disclosure of your personal information under the LEO Pharma Privacy Policy for the purpose of providing this marketing information?

*Required fields are outlined in red

Eligibility Requirements

Eligibility criteria: 1. This card is good for use only with a valid Taclonex® Topical Suspension prescription. 2. This card is valid for up to 6 prescription fills for Taclonex® Topical Suspension. 3. For patients with private health insurance, this card may cover the entire insurance copay or up to $300 of the cash price if you are not insured. 4. Offer good only in the USA at participating retail pharmacies. 5. Original card must be presented to the pharmacist at the time the prescription is filled. Not valid if reproduced. 6. Only one card per patient. 7. The selling, purchasing, trading, or counterfeiting of this card is prohibited by law. 8. Card is not transferable. 9. You must be 12 years of age or older to be eligible. 10. You must be 18 years of age or older to redeem the coupon for yourself or a minor. 11. This card is not health insurance. 12. Claims submitted to private insurers must fully reflect all discounts, rebates, or other reductions in price. 13. This card is not valid for prescriptions reimbursed in whole or in part by Medicaid, Medicare, or other federal or state programs (including any state prescription drug programs), or by private indemnity or HMO health insurance plans that reimburse you for the entire cost of your prescription drugs. Not valid for patients who are Medicare eligible and enrolled in an employer-sponsored health insurance plan or prescription drug benefit program for retirees (i.e., you are eligible for Medicare Part D but receive a prescription drug benefit through a former employer). 14. Offer void where prohibited by law, taxed, or restricted. 15. Not valid in combination with any other offers, discounts, or programs. 16. Card has no cash value. 17. LEO® Pharma Inc. redeems this card and reserves the right to rescind, revoke, or amend this offer without notice. 18. You understand and agree to the terms and conditions as set forth above.

* A different benefit may be available through this program if:

  • Your claim for a Taclonex® product is rejected at the pharmacy because your health insurance plan does not cover the Taclonex® product;
  • Your health insurance plan requires a prior authorization for the Taclonex® product; or,
  • Your health insurance plan requires that you try other medications prior to taking the Taclonex® product.

In such situations, LEO Pharma, the manufacturer of Taclonex® Topical Suspension, may cover the full cost of your prescription for up to a total of six prescription fills. Your participation in the LEO Pharma Copay Card program does not relieve you of your obligations to comply with your health insurance plan’s requirements for future Taclonex® product prescription fills. Please check with your health insurance plan (or other third party payer) regarding restrictions or limitations on your participation in this program or future coverage of Taclonex® products.

INDICATION AND USAGE

Taclonex® Topical Suspension is indicated for the topical treatment of plaque psoriasis of the scalp and body in patients 18 years and older and for plaque psoriasis of the scalp in patients 12 to 17 years. Apply Taclonex® Topical Suspension to affected areas once daily for up to 8 weeks. Therapy should be discontinued when control is achieved. Patients 18 years and older should not use more than 100 g per week and patients 12 to 17 years should not use more than 60 g per week.

IMPORTANT SAFETY INFORMATION

FOR TOPICAL USE ONLY. Taclonex® Topical Suspension is not for oral, ophthalmic, or intravaginal use and should not be applied to the face, axillae, or groin. Do not use if atrophy is present at the treatment site. Do not use with occlusive dressings unless directed by a physician.

Hypercalcemia and hypercalciuria have been observed with use of Taclonex®. If hypercalcemia or hypercalciuria develop, discontinue treatment until parameters of calcium metabolism have normalized. Taclonex® can cause reversible hypothalamic-pituitary-adrenal (HPA) axis suppression with the potential for clinical glucocorticosteroid insufficiency. Use of topical corticosteroids may require that patients be periodically evaluated for HPA axis suppression and calcium abnormalities. If HPA axis suppression is documented, gradually withdraw the drug, reduce the frequency of application, or substitute with a less potent steroid. Cushing’s syndrome and hyperglycemia may also occur in adults due to the systemic effects of the topical corticosteroid. Because of a higher ratio of skin surface area to body mass, pediatric patients are at a greater risk than adults of systemic toxicity, HPA axis suppression and adrenal insufficiency. Rare systemic toxicities such as Cushing’s syndrome, linear growth retardation, delayed weight gain, and intracranial hypertension have been reported in pediatric patients.

In clinical trials, the most common adverse reactions that occurred in 1% of subjects treated with Taclonex® and at a rate higher than in subjects treated with vehicle were folliculitis and burning sensation of skin. Other less common adverse reactions (<1% but >0.1%) were, in decreasing order of incidence: acne, exacerbation of psoriasis, eye irritation, and pustular rash. Local adverse reactions may include atrophy, striae, telangiectasias, burning, itching, irritation, dryness, folliculitis, acneiform dermatitis, hypopigmentation, perioral dermatitis, allergic contact dermatitis, secondary infection, and miliaria and may be more likely with occlusive use or more potent corticosteroids.

Taclonex® may cause eye irritation. Avoid eye exposures. Patients who apply Taclonex® to exposed skin should avoid excessive exposure to either natural or artificial sunlight, including tanning booths, sun lamps, etc. There are no adequate and well-controlled studies of Taclonex® Topical Suspension in pregnant women. Taclonex® should be used during pregnancy only if the potential benefit to the patient justifies the potential risk to the fetus. Because many drugs are excreted in human milk, caution should be exercised when Taclonex® Topical Suspension is administered to a nursing woman. The patient should be instructed not to use Taclonex® Topical Suspension on the breast when nursing. Safety and effectiveness of the use of Taclonex® Topical Suspension in pediatric patients under the age of 12 years have not been established.

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.

Please click here for full Prescribing Information

The health information contained on this Web site is provided for educational purposes only and is not intended to replace discussions with a healthcare professional. All decisions regarding patient care must be made with a healthcare professional.

This site is intended for US residents only. The products discussed on this site may have different product labeling in different countries.

Click here to view the complete Important Safety Information. »

INDICATION AND USAGE

Taclonex® Topical Suspension is indicated for the topical treatment of plaque psoriasis of the scalp and body in patients 18 years and older and for plaque psoriasis of the scalp in patients 12 to 17 years. Apply Taclonex® Topical Suspension to affected areas once daily for up to 8 weeks. Therapy should be discontinued when control is achieved. Patients 18 years and older should not use more than 100 g per week and patients 12 to 17 years should not use more than 60 g per week.

IMPORTANT SAFETY INFORMATION

FOR TOPICAL USE ONLY. Taclonex® Topical Suspension is not for oral, ophthalmic, or intravaginal use and should not be applied to the face, axillae, or groin. Do not use if atrophy is present at the treatment site. Do not use with occlusive dressings unless directed by a physician.

Hypercalcemia and hypercalciuria have been observed with use of Taclonex®. If hypercalcemia or hypercalciuria develop, discontinue treatment until parameters of calcium metabolism have normalized. Taclonex® can cause reversible hypothalamic-pituitary-adrenal (HPA) axis suppression with the potential for clinical glucocorticosteroid insufficiency. Use of topical corticosteroids may require that patients be periodically evaluated for HPA axis suppression and calcium abnormalities. If HPA axis suppression is documented, gradually withdraw the drug, reduce the frequency of application, or substitute with a less potent steroid. Cushing’s syndrome and hyperglycemia may also occur in adults due to the systemic effects of the topical corticosteroid. Because of a higher ratio of skin surface area to body mass, pediatric patients are at a greater risk than adults of systemic toxicity, HPA axis suppression and adrenal insufficiency. Rare systemic toxicities such as Cushing’s syndrome, linear growth retardation, delayed weight gain, and intracranial hypertension have been reported in pediatric patients.

In clinical trials, the most common adverse reactions that occurred in 1% of subjects treated with Taclonex® and at a rate higher than in subjects treated with vehicle were folliculitis and burning sensation of skin. Other less common adverse reactions (<1% but >0.1%) were, in decreasing order of incidence: acne, exacerbation of psoriasis, eye irritation, and pustular rash. Local adverse reactions may include atrophy, striae, telangiectasias, burning, itching, irritation, dryness, folliculitis, acneiform dermatitis, hypopigmentation, perioral dermatitis, allergic contact dermatitis, secondary infection, and miliaria and may be more likely with occlusive use or more potent corticosteroids.

Taclonex® may cause eye irritation. Avoid eye exposures. Patients who apply Taclonex® to exposed skin should avoid excessive exposure to either natural or artificial sunlight, including tanning booths, sun lamps, etc. There are no adequate and well-controlled studies of Taclonex® Topical Suspension in pregnant women. Taclonex® should be used during pregnancy only if the potential benefit to the patient justifies the potential risk to the fetus. Because many drugs are excreted in human milk, caution should be exercised when Taclonex® Topical Suspension is administered to a nursing woman. The patient should be instructed not to use Taclonex® Topical Suspension on the breast when nursing. Safety and effectiveness of the use of Taclonex® Topical Suspension in pediatric patients under the age of 12 years have not been established.

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.

Please click here for full Prescribing Information

The health information contained on this Web site is provided for educational purposes only and is not intended to replace discussions with a healthcare professional. All decisions regarding patient care must be made with a healthcare professional.

This site is intended for US residents only. The products discussed on this site may have different product labeling in different countries.