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`1-844-4MY-TEARS
`(1-844-469-8327)
`
`®
`
`My Tears, My Rewards Program Terms and Conditions
`RESTASIS® (Cyclosporine Ophthalmic Emulsion) 0.05% My Tears, My Rewards® is a savings, counseling, and support program offered to
`eligible patients free of charge. You can enroll and obtain your My Tears, My Rewards® Savings Card through this website, at participating
`physicians' offices, by calling the toll-free customer service support line 1-844-4MY-TEARS (1-844-469-8327), or through a printed offer.
`
`Eligibility
`This program is offered only in the United States and Puerto Rico.
`
`According to state and federal laws, patients covered by Medicare, Medicaid, or a similar federal or state healthcare program are not eligible for
`savings programs.
`
`Patients not eligible for the My Tears, My Rewards® Program are still eligible to enroll in the RESTASIS® My Tears, My SupportTM Program,
`which offers members free information and counseling about treatment with RESTASIS®.
`
`My Tears, My Rewards® Savings Card
`If you printed a Savings Card from this website, it is already activated and you can start using it instantly.
`
`If you received your Savings Card from your doctor, or in the mail, activate it here or call 1-844-4MY-TEARS (1-844-469-8327) and select option
`3.
`
`Go to your pharmacy and present your Savings Card along with your RESTASIS® prescription to your pharmacist.
`
`My Tears, My Rewards® 90-Day Prescription
`Most commercially insured patients pay $0* (save up to $250) on every refill with 90-day RESTASIS® prescriptions.
`
`Offer only valid for a 90-day prescription which comes with 180 vials. No other refill quantities will qualify.
`
`My Tears, My Rewards® 30-Day Prescription
`Most commercially insured patients pay no more than $30* (save up to $250) on every 30-day RESTASIS® prescription.
`
`Offer only valid for a 30-day prescription which comes with 60 vials. No other refill quantities will qualify.
`
`RESTASIS® My Tears, My Rewards® Program for Mail-Order/Manual Claims
`If your mail-order pharmacy or pharmacy does not accept your Savings Card, get a claim form here. Print and complete the form, attach your
`receipt, and send both to the address on the form:
`
`PSKW Attn: RESTASIS® Claims Processing Dept, PO BOX 7017, Bedminster, NJ 07921
`
`You will be mailed a check for the applicable benefit amount. In 3 to 6 weeks your check will arrive in the mail.
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`My Tears, My Rewards® Savings Card Expiration and Re-enrollment
`Your My Tears, My Rewards® Savings Card expires either 1 year from the date you first use it to pay for a prescription, or if you don't use it by
`1/31/2018.
`
`If your Savings Card expires, to get a new one just enroll again here or call 1-844-4MY-TEARS (1-844-469-8327) and select option 3. You will
`instantly get a new Savings Card and other materials necessary to continue to benefit from the program if you:
`• Actively participate in the program‡
`• Use your Savings Card per instructions provided
`
`Allergan reserves the right to revise or discontinue this program at any time and without prior notice or recourse.
`
`*Members whose prescriptions will be paid for in part or in whole by Medicare, Medicaid, or any similar federal or state healthcare program, are
`not eligible for savings or rebates according to federal and state law.
`
`The actual savings on your out-of-pocket costs for RESTASIS® will vary according to refill quantity, personal healthcare insurance coverage, and
`adherence to FDA dosing guidelines. Please review the My Tears, My Rewards® Program guidelines to learn more.
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`https://www.restasis.com/TermsOfUse/TermsAndConditions5
`
`MYLAN - EXHIBIT 1117
`Mylan Pharmaceuticals Inc. et al. v. Allergan, Inc.
`IPR2016-01127, -01128, -01129, -01130, -01131, & -01132
`
`

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`‡Actively participating is defined as: using at least 3 times in the last 10 months for those with 30-day prescriptions and using at least twice in the
`last 10 months for those with 90-day prescriptions.
`
`Approved Use
`RESTASIS® and RESTASIS MultiDose™ Ophthalmic Emulsion help increase your eyes’ natural ability to produce tears, which may be reduced by
`inflammation due to Chronic Dry Eye. RESTASIS® and RESTASIS MultiDose™ did not increase tear production in patients using anti-inflammatory eye
`drops or tear duct plugs.
`
`Important Safety Information
`Do not use RESTASIS® and RESTASIS MultiDose™ Ophthalmic Emulsion if you are allergic to any of the ingredients. Be careful not to touch the container
`tip to your eye or other surfaces, to help avoid eye injury and contamination. RESTASIS® and RESTASIS MultiDose™ should not be used while wearing
`contact lenses. If contact lenses are worn, they should be removed prior to use of RESTASIS® and RESTASIS MultiDose™ and may be reinserted after 15
`minutes.
`
`The most common side effect is a temporary burning sensation. Other side effects include eye redness, discharge, watery eyes, eye pain, foreign body
`sensation, itching, stinging, and blurred vision.
`
`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.
`
`Click here for full Product Information for RESTASIS® and RESTASIS MultiDose™.
`
`Dr. Tendler is an actual RESTASIS® patient and is compensated for appearing on this website.
`
`© 2017 Allergan, Inc. All rights reserved | Privacy Statement | Terms of Use | Contact Us | RES103038_v6 04/17
`This information is intended for residents of the United States. All trademarks are the property of their respective owners.
`
`https://www.restasis.com/TermsOfUse/TermsAndConditions5
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