PrABILIFY MAINTENA®
Patient Assistance Program
The same card for all ABILIFY MAINTENA patients
Information about the program and FAQs:
Otsuka Canada Pharmaceutical Inc. and Lundbeck Canada Inc. are pleased to offer financial support for
patients prescribed ABILIFY MAINTENA (aripiprazole for prolonged release injectable suspension).
The multi-use program will automatically cover a portion of the prescription cost.* The Certificate numbers provided on the downloadable card, can be used for all ABILIFY MAINTENA patients. No cards are required. Limit of one certificate per patient.
* Based on reasonable mark-up and customary pharmacy fee.
You can use the same certificate number for all patients. If you have any questions regarding claims processing,
please call the ClaimSecure HelpDesk at 1-800-461-6579.
Payment and processing information for the ABILIFY MAINTENA program
- The payment for the claims should be processed through ClaimSecure in the following manner:
- Select ClaimSecure as the “Third Party Payer”
- Enter the Certificate number (10 digits) as it appears above, then enter the Group number 37384
- Select Cardholder as the Relationship Code
- No expiry date required
If your patient has an electronic drug plan (either public or private), please enter Abilify Maintena program information as the SECONDARY plan. Send the claim to your patient’s regular drug plan first and then co-ordinate the claim with ClaimSecure for a portion of the difference.
If your patient does not have drug coverage or a pay direct plan, please contact the PANORAMA® Patient Support Program at 1-844-788-8041.
Coverage may vary based on patient plan. Limit one program certificate per patient. Program valid only in Canada. Program may change or expire at any time without notice.