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My QUTENZA Connect Cost Savings Program can help cover costs related to treatment with QUTENZA

Register your practice with MQC at .
Help your patients with painful diabetic peripheral neuropathy (DPN) of the feet or postherpetic neuralgia (PHN) save on their QUTENZA treatment.

Medication Savings
Administration Savings

My QUTENZA Connect Cost
Savings Program

Patients may be eligible for the cost savings program if they:

  • Are using QUTENZA for an FDA-approved use
  • Are 18 years of age or older
  • Have commercial (private) insurance that covers QUTENZA
  • Live and receive treatment in the United States
  • Do not use a state or federal healthcare plan to pay for their medication – this includes, but is not limited to, Medicare, Medicaid, and TRICARE


Accessing cost savings for your patients

Requesting Reimbursement for Buy-and-Bill

Register your practice with the My QUTENZA Connect Cost Savings Program at .

Mail and fax submission options are available. Call 833-295-3579 to learn more.


Processing Cost Savings Through a Specialty Pharmacy

When you use a specialty pharmacy for QUTENZA, the specialty pharmacy will submit and process the claim with the My QUTENZA Connect Cost Savings Program listed as the patient's secondary insurance.

Claims will be processed in approximately four weeks.

It may take up to two business days to receive notification of account activation.

Eligibility Criteria, Terms, and Conditions:

By using this offer, you confirm that you currently meet all eligibility criteria and will comply with all terms and conditions, as described below:

  1. The My QUTENZA Connect Cost Savings Program (the “Program”) is available only to eligible adult patients prescribed QUTENZA for use consistent with approved indications in US product labeling for QUTENZA. Eligible patients must reside in the US, Puerto Rico, or the US territories based on the patient’s address and must be insured by a commercial insurer that covers QUTENZA and does not prohibit participation in patient assistance programs. Uninsured or cash-paying patients and patients with coverage for QUTENZA through federal- or state-funded government healthcare programs, including Medicare, Medicaid, Medigap, TRICARE, Veterans Affairs (VA), or Department of Defense (DoD), are not eligible for the Program, with the exception of the Federal Employees Health Benefit (FEHB) Program for the purpose of this Program. A patient who begins receiving benefits for QUTENZA from a government healthcare program will no longer be eligible for the Program.
  2. This Program will only accept applications by mail. Healthcare providers may also submit applications via fax or through the My QUTENZA Connect portal. No phone or email requests will be accepted or honored. Applications must be fully completed based on the instructions stated on the registration form. Averitas Pharma, Inc., is not responsible for lost, late, damaged, misdirected, incomplete, or illegible submissions. All submissions become the property of Averitas Pharma, Inc., and its agents. Please retain copies of any materials you submit.
  3. Any refund under this Program may not exceed the eligible patient’s medication and/or administration co-payment, co-insurance, or deductible costs (“Patient Responsibility”) for QUTENZA, whether covered under the medical or pharmacy benefit. For pharmacy claims associated with the medication, this offer can be used only with a valid QUTENZA prescription at the time the prescription is filled by the pharmacist and dispensed to the patient, and is good only at participating pharmacies in the US.
  4. The Program is valid for the patient’s out-of-pocket costs for the medication and cannot be used if the patient is eligible to be reimbursed for the entire cost of QUTENZA. The patient and the patient’s healthcare provider may not seek any other reimbursement of Patient Responsibility for the medication.
  5. The Program is valid for the patient’s total out-of-pocket costs for the administration of QUTENZA and cannot be used if the patient is eligible to be reimbursed for the cost of the administration of QUTENZA. The patient and the patient’s healthcare provider may not seek other reimbursement of Patient Responsibility for the administration of QUTENZA. Applications for the full refund for the administration of QUTENZA are not eligible for the Program and will not be approved if the healthcare provider’s administration costs are not covered or reimbursed by the patient’s insurance.
  6. Patient Responsibility for the medication must be isolated on the claim and separate from other services and products. A patient may not apply for reimbursement of Patient Responsibility under the Program if the patient’s healthcare provider has already sought reimbursement under the Program, and the patient’s healthcare provider may not seek such reimbursement of Patient Responsibility under the Program if the patient has already applied for reimbursement under the Program.
  7. Refunds will be processed in the order in which they are received. Approved claims will be processed and paid in the subsequent billing cycle. Please allow approximately 4 weeks for delivery of refund checks. Tampering with, altering, or falsifying payment information is prohibited by law.
  8. The Program is effective as of January 1, 2024, for treatments administered after this date. This offer is limited to 1 per person, is nontransferable, and is valid for the eligible patient only. No other purchase is necessary. This offer has no cash value and cannot be combined with any other patient assistance program, free trial, discount, prescription savings card, or other offer. Averitas Pharma, Inc., reserves the right to cancel, modify, or rescind this Program at any time. Aggregate and non-identifiable patient information may be used by Averitas Pharma, Inc., for market research and other related purposes. This Program is not insurance and is not intended to substitute for insurance. This offer is void where prohibited or restricted by law.

INDICATION

QUTENZA® (capsaicin) 8% topical system is indicated in adults for the treatment of neuropathic pain associated with postherpetic neuralgia (PHN) or associated with diabetic peripheral neuropathy (DPN) of the feet.

IMPORTANT SAFETY INFORMATION

Do not dispense QUTENZA to patients for self‑administration or handling. Use only on dry, unbroken skin. Only physicians or healthcare professionals are to administer and handle QUTENZA, following the procedures in the label.

Warnings and Precautions

  • Severe Irritation: Whether applied directly or transferred accidentally from other surfaces, capsaicin can cause severe irritation of eyes, mucous membranes, respiratory tract, and skin to the healthcare professional, patients, and others. Do not use near eyes or mucous membranes, including face and scalp. Take protective measures, including wearing nitrile gloves and not touching items or surfaces that the patient may also touch. Flush irritated mucous membranes or eyes with water and provide supportive medical care for shortness of breath. Remove affected individuals from the vicinity of QUTENZA. Do not re‑expose affected individuals to QUTENZA if respiratory irritation worsens or does not resolve. If skin not intended to be treated comes into contact with QUTENZA, apply Cleansing Gel and then wipe off with dry gauze. Thoroughly clean all areas and items exposed to QUTENZA and dispose of properly. Because aerosolization of capsaicin can occur with rapid removal, administer QUTENZA in a well‑ventilated area, and remove gently and slowly, rolling the adhesive side inward.
  • Application-Associated Pain: Patients may experience substantial procedural pain and burning upon application and following removal of QUTENZA. Prepare to treat acute pain during and following application with local cooling (e.g., ice pack) and/or appropriate analgesic medication.
  • Increase in Blood Pressure: Transient increases in blood pressure may occur with QUTENZA treatment. Monitor blood pressure during and following treatment procedure and provide support for treatment‑related pain. Patients with unstable or poorly controlled hypertension, or a recent history of cardiovascular or cerebrovascular events, may be at an increased risk of adverse cardiovascular effects. Consider these factors prior to initiating QUTENZA treatment.
  • Sensory Function: Reductions in sensory function (generally minor and temporary) have been reported following administration of QUTENZA. All patients with sensory deficits should be assessed for signs of sensory deterioration or loss prior to each application of QUTENZA. If sensory loss occurs, treatment should be reconsidered.

Adverse Reactions

The most common adverse reactions (≥5% and > control group) in all controlled clinical trials are application site erythema, application site pain, and application site pruritus.

To report SUSPECTED ADVERSE REACTIONS, contact Averitas Pharma, Inc. at 1‑877‑900‑6479 or FDA at 1‑800‑FDA‑1088 or .

Please see full Prescribing Information.

INDICATION

QUTENZA® (capsaicin) 8% topical system is indicated in adults for the treatment of neuropathic pain associated with postherpetic neuralgia (PHN) or associated with diabetic peripheral neuropathy (DPN) of the feet.

IMPORTANT SAFETY INFORMATION

Do not dispense QUTENZA to patients for self‑administration or handling. Use only on dry, unbroken skin. Only physicians or healthcare professionals are to administer and handle QUTENZA, following the procedures in the label.

Warnings and Precautions

  • Severe Irritation: Whether applied directly or transferred accidentally from other surfaces, capsaicin can cause severe irritation of eyes, mucous membranes, respiratory tract, and skin to the healthcare professional, patients, and others. Do not use near eyes or mucous membranes, including face and scalp. Take protective measures, including wearing nitrile gloves and not touching items or surfaces that the patient may also touch. Flush irritated mucous membranes or eyes with water and provide supportive medical care for shortness of breath. Remove affected individuals from the vicinity of QUTENZA. Do not re‑expose affected individuals to QUTENZA if respiratory irritation worsens or does not resolve. If skin not intended to be treated comes into contact with QUTENZA, apply Cleansing Gel and then wipe off with dry gauze. Thoroughly clean all areas and items exposed to QUTENZA and dispose of properly. Because aerosolization of capsaicin can occur with rapid removal, administer QUTENZA in a well‑ventilated area, and remove gently and slowly, rolling the adhesive side inward.
  • Application-Associated Pain: Patients may experience substantial procedural pain and burning upon application and following removal of QUTENZA. Prepare to treat acute pain during and following application with local cooling (e.g., ice pack) and/or appropriate analgesic medication.
  • Increase in Blood Pressure: Transient increases in blood pressure may occur with QUTENZA treatment. Monitor blood pressure during and following treatment procedure and provide support for treatment‑related pain. Patients with unstable or poorly controlled hypertension, or a recent history of cardiovascular or cerebrovascular events, may be at an increased risk of adverse cardiovascular effects. Consider these factors prior to initiating QUTENZA treatment.
  • Sensory Function: Reductions in sensory function (generally minor and temporary) have been reported following administration of QUTENZA. All patients with sensory deficits should be assessed for signs of sensory deterioration or loss prior to each application of QUTENZA. If sensory loss occurs, treatment should be reconsidered.

Adverse Reactions

The most common adverse reactions (≥5% and > control group) in all controlled clinical trials are application site erythema, application site pain, and application site pruritus.

To report SUSPECTED ADVERSE REACTIONS, contact Averitas Pharma, Inc. at 1‑877‑900‑6479 or FDA at 1‑800‑FDA‑1088 or .

Please see full Prescribing Information.