ORGOVYX® (relugolix) Support Program logo

We are dedicated to providing ongoing support to help patients
prescribed ORGOVYX start and stay on track.

CHOOSE 1 OF 3 EASY WAYS TO ENROLL YOUR PATIENTS TODAY
DOWNLOAD

Download the ORGOVYX Support Program Start Form, print, and complete the form, then fax it to 1-844-826-8875.

CALL

Call toll-free 1-833-ORGOVYX
(1-833-674-6899)
,
Monday-Friday, 8 AM-8 PM ET.

E-PRESCRIBE

When e-prescribing ORGOVYX to the Mercalis Pharmacy, enrollment in the
ORGOVYX Support Program is available.

The ORGOVYX Support
Program includes:

ORGOVYX® (relugolix) Copay Assistance Program Card
Financial Assistance*

As a part of the ORGOVYX Copay Assistance Program, eligible, commercially insured patients may pay as little as $10 per prescription, with a maximum savings per calendar year of $10,000. See program terms and conditions below.

Enroll patients
Reimbursement Support

We can assist your patients with access challenges, including providing information about benefit verification, prior authorizations, and appeals processes.

Learn more
ORGOVYX Education

Provides educational resources to help support patients.

Learn more

Additional resources

FORMULARY LOOKUP TOOL

Find coverage information for patients in different ZIP codes.

Search your area
DISTRIBUTION NETWORK

Find which pharmacies are eligible to order ORGOVYX.

Learn more

ORGOVYX Copay Assistance Program Terms, Conditions, and Eligibility Criteria

*Eligibility required. Commercially insured patients only. This copay program is subject to a calendar year maximum savings of $10,000. After the calendar year maximum savings is reached, patient will be responsible for the remaining out-of-pocket costs for ORGOVYX. The Copay Program is not valid for patients participating in Medicare, Medicaid, or other government healthcare programs. No membership fees. This offer is not health insurance. Available only to patients who have been diagnosed with an FDA-approved indication for ORGOVYX. Terms and conditions apply. For full program terms, conditions, and eligibility criteria please visit www.orgovyx.com/terms-and-conditions.

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