IMPORTANT SAFETY INFORMATION:

Financial Assistance

Programs to Make Sucraid® Affordable

The financial burden for managing a rare disease can be significant; however, many patients qualify for financial support. The SucraidASSIST™ program can assist in connecting eligible patients to a range of available financial assistance. Contact the specialty pharmacy at 1-800-705-1962 for more information.

SucraidASSIST Patient Assistance Program

Program qualifications and eligibility requirements include:

  • U.S. residency
  • Valid prescription for Sucraid®
  • Completed Health Insurance Portability and Accountability Act (HIPAA) form
  • Enrollment in the SucraidASSIST™ program
  • Income eligibility is below 200% of the current Federal Poverty Level, which varies by household income based on household size
Financial assistance program:
  • Financial assistance may be available for patients who meet these income and other eligibility requirements

Copay and/or Deductible Savings Program

Sucraid® Savings Program Eligibility Criteria/Terms and Conditions:

By using the Sucraid® Savings Program, you confirm that you understand and agree to the following terms and conditions:

  • This offer is valid for commercially-insured patients being treated with Sucraid® for an FDA-approved indication.
  • For Sucraid®, patient is responsible for $5 per Sucraid® prescription filled, with a maximum annual benefit of up to $10,000.
  • This offer is not valid for any patient that receives (or is eligible to receive) coverage or reimbursement (in full or in part) for medical treatment and/or prescription drugs through any federal, state, or other government health insurance program (including, but not limited to, Medicare, including Medicare Part D plans, Medicaid, Veterans Administration health coverage, TRICARE or other Department of Defense health coverage, or the Puerto Rico Government Health Insurance Plan). Uninsured and cash-pay patients are not eligible to participate in this program. This offer does not constitute insurance coverage.
  • This offer is open to patients residing in the United States (including the District of Columbia and Puerto Rico), except where prohibited by law or otherwise restricted.
  • Patient must be receiving treatment from a physician in the United States and product must be dispensed at participating eligible pharmacies in the United States, Puerto Rico, or U.S. territories.
  • Patient must be at least 18 years of age to redeem this offer (either for yourself or on behalf of a minor).
  • Patient agrees to not seek insurance coverage or reimbursement for the prescription filled, or any part of the value received through this offer. Patient is responsible for reporting utilization of the Sucraid® Savings Program as required by any insurer (or other third-party payer) who pays for any part of the prescription filled.
  • Patients receiving free Sucraid® are not eligible to participate in this offer. This offer is not valid with other offers for Sucraid® and cannot be combined with other financial assistance programs for Sucraid®.
  • This offer is not transferable and may not be combined with any other offer. The selling, purchasing, trading, or counterfeiting of this assistance is prohibited.
  • Offer must be presented along with a valid prescription for Sucraid®. No other purchase is necessary to redeem this offer.
  • QOL Medical intends for the full value of the program benefits to be exclusively provided to the patient.
  • QOL Medical reserves the right to change or discontinue this offer at any time without notice.
  • This card is valid for one year from date of enrollment. Offer limited to one card per person.
  • For questions about the Sucraid®Savings Program, call 1-855-672-4110 (Monday through Friday, 8 am – 8 pm EST).

Please contact the specialty pharmacy to see if you may qualify for financial assistance. 1-800-705-1962.

Important Safety Information for Sucraid® (sacrosidase) Oral Solution

  • Sucraid® may cause a serious allergic reaction. If you notice any swelling or have difficulty breathing, get emergency help right away.
  • Tell your doctor if you are allergic to, have ever had a reaction to, or have ever had difficulty taking yeast, yeast products, papain, or glycerin (glycerol).
  • Sucraid® does not break down some sugars that come from the digestion of starch. You may need to restrict the amount of starch in your diet. Your doctor will tell you if you should restrict starch in your diet.
  • Tell your doctor if you have diabetes, as your blood glucose levels may change if you begin taking Sucraid®. Your doctor will tell you if your diet or diabetes medicines need to be changed.
  • Some patients treated with Sucraid® may have worse abdominal pain, vomiting, nausea, or diarrhea. Constipation, difficulty sleeping, headache, nervousness, and dehydration have also occurred in patients treated with Sucraid®. Check with your doctor if you notice these or other side effects.
  • Sucraid® has not been tested to see if it works in patients with secondary (acquired) sucrase deficiency.
  • NEVER HEAT SUCRAID® OR PUT IT IN WARM OR HOT BEVERAGES OR INFANT FORMULA. Do not mix Sucraid® with fruit juice or take it with fruit juice. Take Sucraid® as prescribed by your doctor. Normally, half the dose of Sucraid® is taken before a meal or snack and the other half is taken during the meal or snack.
  • Sucraid® should be refrigerated at 36°F-46°F (2°C-8°C) and should be protected from heat and light.

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.

Indication

Sucraid® (sacrosidase) Oral Solution is an enzyme replacement therapy for the treatment of genetically determined sucrase deficiency, which is part of Congenital Sucrase-Isomaltase Deficiency (CSID).