ZORYVE DIRECT
for AFFORDABLE
PATIENT ACCESS
One ZORYVE Direct Savings Program helps eligible, commercially insured patients get access and start ZORYVE treatment quickly and easily*
Scan the QR code or text SAVE to:
440-4ZORYVE (440-496-7983)
Savings
Program
Patient Access
Support
Adherence
Support
Eligible patients with commercial drug insurance may
pay as little as $0 for ZORYVE†
*Prescriptions will be delivered to the patient 1–2 days after processing.
†Subject to eligibility criteria and maximum program limitation. This offer is not valid for patients without commercial drug insurance or whose
prescription claims are eligible to be reimbursed, in whole or in part, by any government program. Please see Terms and Conditions.
Encourage your patients to sign up
Get patients started on ZORYVE
Consider including the following information in the notes to the pharmacist if clinically appropriate:
Plaque Psoriasis
Possible ICD-10 Code(s)3:
L40.0: Psoriasis vulgaris
L40.8: Other psoriasis
L40.9: Psoriasis, unspecified
All medications tried and failed, if any4:
Topical corticosteroids
Topical vitamin D analogs (eg, calcipotriene)
Topical calcineurin inhibitors
Combination therapy
Other considerations, if applicable:
Special treatment locations
(eg, face/eyelids, genitals, scalp, and skin folds)
Body surface area (BSA)
Disease severity (eg, IGA)
Other required documentation
This information is provided for your background and not intended as comprehensive or directive. Payer requirements may vary or change over time. It is your responsibility to determine and submit the appropriate codes and supporting information for medically necessary treatment. This information is in no way a guarantee of reimbursement or coverage for any product or service.
Atopic Dermatitis
Possible ICD-10 Code(s)3:
L20.0: Besnier’s prurigo (atopic dermatitis)
L20.8: Other atopic dermatitis
L20.9: Atopic dermatitis, unspecified
All medications tried and failed, if any5:
Topical corticosteroids
Topical calcineurin inhibitors
Other considerations, if applicable:
Special treatment locations
(eg, face/eyelids, genitals, scalp, and skin folds)
Body surface area (BSA)
Disease severity (eg, IGA)
Other required documentation
This information is provided for your background and not intended as comprehensive or directive. Payer requirements may vary or change over time. It is your responsibility to determine and submit the appropriate codes and supporting information for medically necessary treatment. This information is in no way a guarantee of reimbursement or coverage for any product or service.
Seborrheic Dermatitis
Possible ICD-10 Code(s)3:
L21.8: Other seborrheic dermatitis
L21.9: Seborrheic dermatitis, unspecified
All medications tried and failed, if any6:
Topical corticosteroids
Topical antifungals (eg, topical ketoconazole)
Topical calcineurin inhibitors
Other considerations, if applicable:
Special treatment locations
(eg, face/eyelids, genitals, scalp, and skin folds)
Body surface area (BSA)
Disease severity (eg, IGA)
Other required documentation
This information is provided for your background and not intended as comprehensive or directive. Payer requirements may vary or change over time. It is your responsibility to determine and submit the appropriate codes and supporting information for medically necessary treatment. This information is in no way a guarantee of reimbursement or coverage for any product or service.
Plaque Psoriasis
Atopic Dermatitis
Seborrheic Dermatitis
Possible ICD-10 Code(s)3:
L40.0: Psoriasis vulgaris
L40.8: Other psoriasis
L40.9: Psoriasis, unspecified
All medications tried and failed, if any4:
Topical corticosteroids
Topical vitamin D analogs (eg, calcipotriene)
Topical calcineurin inhibitors
Combination therapy
Other considerations, if applicable:
Special treatment locations
(eg, face/eyelids, genitals, scalp, and skin folds)
Body surface area (BSA)
Disease severity (eg, IGA)
Other required documentation
This information is provided for your background and not intended as comprehensive or directive. Payer requirements may vary or change over time. It is your responsibility to determine and submit the appropriate codes and supporting information for medically necessary treatment. This information is in no way a guarantee of reimbursement or coverage for any product or service.
Arcutis CaresTM Patient Assistance Program is available for financially eligible patients
who are uninsured or underinsured.‡
For additional program and application information, visit arcutiscares.com.
‡Subject to financial eligibility requirements. Other terms and restrictions apply.