Terms, Conditions, and Eligibility Requirements:

To the Patient:

The BIMZELX Navigate^® program is provided as a service of UCB and is intended to support the appropriate use of BIMZELX. The BIMZELX Navigate program may be amended or canceled at any time without notice. Some program and eligibility restrictions may apply.

Eligible patients may pay $5 per dose. Available to individuals 18 years of age or older with commercial insurance coverage with a valid prescription consistent with FDA-approved product labeling for BIMZELX® (bimekizumab- bkzx). Not valid (1) for prescriptions that are reimbursed, in whole or in part, under Medicare (including Medicare Part D), Medicaid, or any other federal- or state-funded healthcare programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico), (2) where a patient’s commercial insurance plan reimburses for the entire cost of the drug, (3) for uninsured or cash paying patients, or (4) where otherwise prohibited by law. Product shall be dispensed pursuant to program rules and federal and state laws. The value of the program is exclusively for the benefit of patients and is intended to be credited in full towards patient out-of-pocket obligations and maximums, including applicable co-payments, coinsurance and deductibles. Patient may not seek reimbursement for the value of this program from other parties, including third party payers (ie, any health insurance program or plan, or public payers like Medicare, Medicaid, Medigap, TRICARE, VA, and DoD). Patient is responsible for any costs once limit is reached in a calendar year. Patient is responsible for complying with any applicable limitations and requirements of their health plan related to the use of the program. This program cannot be combined with any other savings, free trial, or similar offer for the specified prescription. UCB reserves the right to amend or end this program at any time without notice.

If you are uninsured, other financial assistance may be available. Call ucbCARES® toll free at 1-844-599-CARE (2273) for more information.

To the Pharmacist:

When you apply this offer, you are certifying that this patient meets the outlined eligibility requirements, including that you have not submitted and will not submit a claim for reimbursement under any federal, state, or other governmental program for this prescription.

UCB, Inc., is not liable for unintended or unauthorized use of the BIMZELX Navigate Savings Card if it is lost or stolen.

Please visit BIMZELX.com for full Prescribing Information.