IPSEN CARES® Copay Eligibility, Terms & Conditions

Patients are not eligible for copay assistance through IPSEN CARES® if they are enrolled in any state or federally funded programs for which drug prescriptions or coverage could be paid in part or in full, including, but not limited to, Medicare Part B, Medicare Part D, Medicaid, Medigap, VA, DoD, or TRICARE (collectively, “Government Programs”), or where prohibited by law. Patients must be United States residents (including its territories) and enrolled in IPSEN CARES® to receive copay program benefits. Patients receiving assistance through another assistance program or foundation, free trial, or other similar offer or program, are not eligible for the copay assistance program during the current enrollment year.

An annual calendar year maximum copay benefit applies.

Patients may remain enrolled in copay assistance as long as eligibility criteria is met.

Patients or guardians are responsible for reporting receipt of copay savings benefit to any insurer, health plan, or other third party who pays for or reimburses any part of the prescription filled through the program, as may be required. Additionally, patients or guardians may not submit any benefit provided by this program for reimbursement through a Flexible Spending Account, Health Savings Account, Health Reimbursement Account, or otherwise to a government or private payor. Ipsen reserves the right to rescind, revoke, or amend these offers without notice at any time. Ipsen and/or its copay assistance vendor are not responsible for any transactions processed under this program where Medicaid, Medicare, or Medigap payment in part or full has been applied. Data related to patient participation may be collected, analyzed, and shared with Ipsen for market research and other purposes related to assessing the program. Data shared with Ipsen will be de-identified, meaning it will not identify the patient. Void outside of the United States and its territories or where prohibited by law, taxed, or restricted. This program is not health insurance. No other purchase is necessary. Copay assistance cannot be sold, purchased, traded, or counterfeited. Void if reproduced.

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IPSEN CARES is a registered trademark of Ipsen Biopharm Limited.

©2025 Ipsen Biopharmaceuticals, Inc. All rights reserved.
[Month] 2025 MPSC-US-000292 V1.0

DYSPORT is a registered trademark of Ipsen S.A.

All other trademarks and registered trademarks are the property
of their respective owners.

DYSPORT is a registered trademark of Ipsen Biopharm Limited.

IPSEN CARES is a registered trademark of Ipsen S.A.

All other trademarks and registered trademarks are the property of their respective owners.

©2025 Ipsen Biopharmaceuticals, Inc. All rights reserved. August 2025 MPSC-US-000292