®
`
`ENROLL
`Need a savings card?* Enroll in the OPENINGS
`Patient Support Program to download one now,
`plus get access to other valuable program
`benefits.
`Enroll Now ›
`
`OPENINGS Savings Card
`®
`Terms and Conditions
`®
`The OPENINGS Program savings card is provided by Alcon. The savings card
`provides savings on out-of-pocket expenses for up to a 90-day supply of
`®
`®
`®
`TRAVATAN Z Solution, SIMBRINZA Suspension and/or AZOPT Suspension,
`as described below. If you have valid prescriptions for more than one product,
`the copay expense and savings apply to each product. You may use the savings
`card once every 30, 60, or 90 days, depending on when you last received a 30-,
`60-, or 90-day supply of each Alcon product. Use of the savings card does not
`obligate you to use or to continue using any Alcon product. You may use the
`savings card at any participating pharmacy located in the United States.
`®
`The OPENINGS Program savings card may not be combined with any savings,
`discount, free trial, or other similar offer for the same prescription. The savings
`card is not transferable and is void if reproduced. The savings card is not health
`®
`insurance. Limit 1 savings card per patient. The OPENINGS Program savings
`card has no cash value. Please visit Alcon’s website for our privacy practices.
`Alcon reserves the right to revoke or amend this offer without notice at any time
`and to deny payment for noncompliance with the terms of this offer. This offer
`expires June 30, 2016, unless this offer is earlier terminated by Alcon.
`Use of this savings card is subject to applicable state and federal law, and is
`void where prohibited. In the event an A rated generic equivalent product
`becomes available for one of the products covered by this savings card, this
`offer will become void in Massachusetts with respect to that product.
`Eligibility:
`®
`By using the OPENINGS Program savings card, you acknowledge that you
`currently meet the following eligibility criteria:
`®
`You have a valid prescription for TRAVATAN Z Solution,
`®
`®
`SIMBRINZA Suspension, or AZOPT Suspension;
`You have no insurance or are subject to a private insurance copay
`requirement for your prescription;
`You are not enrolled in Medicare Part D, Medicaid, Medigap, VA,
`DOD, Tricare, or any other government-run or government
`sponsored health care program with a pharmacy benefit;
`No purchase is necessary and there are no membership fees;
`You are at least 18 years old; and
`You reside in the United States.
`Minimum out-of-pocket expenses and maximum coverage amounts
`Eligible commercially insured patients are responsible for paying out-of-pocket
`expenses noted below and any amount that exceeds the Alcon payment for
`each prescription, as follows:
`®
`For a 30-day supply (2.5 mL of TRAVATAN Z Solution, 8 mL of
`®
`®
`SIMBRINZA Suspension or 10 mL of AZOPT Suspension), patient pays
`$25 out of pocket and Alcon will pay up to $105 of any remaining balance.
`®
`For a 60-day supply (5 mL of TRAVATAN Z Solution, 16 mL of
`®
`®
`SIMBRINZA Suspension or 15-25 mL of AZOPT Suspension), the
`patient pays $50 out of pocket and Alcon will pay up to $210 of any
`remaining balance.
`®
`For a 90-day supply (7.5 mL of TRAVATAN Z Solution, 24 mL of
`®
`®
`SIMBRINZA Suspension or 30 mL of AZOPT Suspension), patient pays
`$50 out of pocket and Alcon will pay up to $365 of any remaining balance.
`Eligible uninsured cash paying patients save on actual out-of-pocket costs off
`the usual and customary retail price, as follows:
`®
`For a 30-day supply (2.5 mL of TRAVATAN Z Solution, 8 mL of
`®
`®
`SIMBRINZA Suspension, or 10 mL of AZOPT Suspension), patients
`save up to $60 on actual out-of-pocket costs off the usual and customary
`price.
`Exhibit 1036
`®
`For a 60-day supply (5 mL of TRAVATAN Z Solution, 16 mL of
`ARGENTUM
`®
`®
`SIMBRINZA Suspension, or 15-25 mL of AZOPT Suspension), patients
`
`ACTIVATE
`Already have a savings card?
`Activate Now ›
`
`Already Registered?
`Log In Now › to update your reminders, access
`materials and more.
`
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`
`

`

`save up to $120 on actual out-of-pocket costs off the usual and customary
`price.
`®
`For a 90-day supply (7.5 mL of TRAVATAN Z Solution, 24 mL of
`®
`®
`SIMBRINZA Suspension, or 30 mL of AZOPT Suspension), patients
`save up to $180 on actual out-of-pocket costs off the usual and customary
`price.
`®
`Offer is good for up to 12 bottles each of TRAVATAN Z Solution,
`®
`®
`SIMBRINZA Suspension, and/or AZOPT Suspension for a single patient. No
`other purchase necessary.
`®
`TRAVATAN Z Solution is available in 2.5 mL and 5 mL,
`®
`®
`SIMBRINZA Suspension is available in 8 mL and AZOPT Suspension is
`available in 10 mL and 15 mL bottles. Unless the patient’s health insurer requires
`that a particular-sized bottle be used, patients may use any combination of
`bottles to satisfy the 30-, 60- and 90-day quantities.
`This offer may be subject to limitations imposed by state or federal law, or by
`®
`your health insurer. The OPENINGS Program savings card is not valid where
`prohibited by law or by your health insurer.
`Patient instructions: You must call (866) 972-3008 or visit
`openingsprogram.com/join to activate your savings card. Then present the
`®
`OPENINGS Program savings card to your pharmacist along with an eligible
`®
`®
`prescription for TRAVATAN Z Solution, SIMBRINZA Suspension, and/or
`®
`AZOPT Suspension each time you fill your prescription. The prescriber ID#
`must be identified on the prescription. When you use this card, you are certifying
`that you understand the program rules, regulations, and terms and conditions
`and that you will comply with them. You may not use this card if prohibited by
`your insurer. You are responsible for any reporting of the use of this card
`required by your insurer. If you have any questions, please call the OPENINGS
`Program at (866) 972-3008.
`Pharmacist Instructions for a Patient with an Eligible Third Party
`When you use this card, you are certifying that you have not submitted and will
`not submit a claim for reimbursement under any federal, state, government-run
`or government sponsored health care program with a pharmacy benefit. If
`primary coverage exists, input card information as secondary coverage and
`transmit using the COB segment of the NCPDP transaction. Submit transaction
`to McKesson Corporation using BIN #610524. Acceptable discounts will be
`displayed in the transaction response. Acceptance of this card and your
`submission of claims are also subject to the Terms and Conditions posted at
`www.mckesson.com/mprstnc.
`Pharmacist Instructions for an Uninsured Patient
`For uninsured cash-paying patients, submit transaction to McKesson
`Corporation using BIN #610524. Acceptable discounts will be displayed in the
`transaction response. Acceptance of this card and your submission of claims are
`also subject to the Terms and Conditions posted at
`www.mckesson.com/mprstnc.
`For questions regarding setup, claim transmission, patient eligibility or
`®
`®
`other issues, call the LoyaltyScript for OPENINGS Program at 844-236-
`8027 (8:00 AM-8:00 PM EST, Monday-Friday).
`Alcon reserves the right to rescind, revoke or amend this offer at any time.
`®
`®
`Important information about SIMBRINZA
`Important information about AZOPT
`(brinzolamide/brimonidine tartrate
`(brinzolamide ophthalmic suspension) 1%
`ophthalmic suspension) 1%/0.2%
`INDICATIONS AND USAGE
`INDICATIONS AND USAGE
`®
`AZOPT Suspension is a carbonic anhydrase
`®
`SIMBRINZA Suspension is a fixed
`inhibitor (CAI) indicated in the treatment of
`combination indicated in the reduction of
`elevated intraocular pressure in patients with
`elevated intraocular pressure (IOP) in patients
`ocular hypertension or open-angle glaucoma.
`with open-angle glaucoma or ocular
`Dosage and Administration
`hypertension.
`The recommended dose is one drop of
`Dosage and Administration
`®
`AZOPT Suspension in the affected eye(s)
`The recommended dose is one drop of
`three times daily. If more than one topical
`SIMBRINZA Suspension in the affected
`ophthalmic drug is being used, the drugs
`eye(s) three times daily. Shake well before use.
`should be administered at least ten (10)
`SIMBRINZA Suspension may be used
`minutes apart.
`concomitantly with other topical ophthalmic
`IMPORTANT SAFETY INFORMATION
`drug products to lower intraocular pressure. If
`more than one topical ophthalmic drug is being
`Contraindications
`used, the drugs should be administered at least
`®
`AZOPT Suspension is contraindicated in
`five (5) minutes apart.
`patients who are hypersensitive to any
`component of this product.
`IMPORTANT SAFETY INFORMATION
`
`® ®
`
`®
`
`Important information about
`®
`TRAVATAN Z (travoprost ophthalmic
`solution) 0.004%
`INDICATIONS AND USAGE
`®
`TRAVATAN Z Solution is indicated for the
`reduction of elevated intraocular pressure (IOP)
`in patients with open-angle glaucoma or ocular
`hypertension.
`Dosing and Administration
`The recommended dosage is one drop in the
`affected eye(s) once daily in the evening.
`®
`TRAVATAN Z Solution should not be
`administered more than once daily since it has
`been shown that more frequent administration
`of prostaglandin analogs may decrease the
`IOP lowering effect.
`®
`TRAVATAN Z Solution may be used
`concomitantly with other topical ophthalmic
`drug products to lower IOP. If more than one
`topical ophthalmic drug is being used, the
`
`000002
`
`

`

`Warnings and Precautions
`Sulfonamide Hypersensitivity Reactions -
`®
`AZOPT Suspension is a sulfonamide and
`although administered topically it is absorbed
`systemically. The same types of adverse
`reactions that are attributable to sulfonamides
`may occur with topical administration of
`®
`AZOPT Suspension. Fatalities have occurred,
`although rarely, due to severe reactions to
`sulfonamides. Sensitization may recur when a
`sulfonamide is re-administered irrespective of
`the route of administration. If signs of serious
`reactions or hypersensitivity occur, discontinue
`the use.
`Corneal Endothelium - Carbonic anhydrase
`activity has been observed in both the
`cytoplasm and around the plasma membranes
`of the corneal endothelium. There is an
`increased potential for developing corneal
`edema in patients with low endothelial cell
`counts. Caution should be used when
`®
`prescribing AZOPT Suspension to this group
`of patients.
`Severe Renal Impairment -
`®
`AZOPT Suspension has not been studied in
`patients with severe renal impairment (CrCl ≥
`®
`30 mL/min). Because AZOPT Suspension
`and its metabolite are excreted predominantly
`®
`by the kidney, AZOPT Suspension is not
`recommended in such patients.
`Acute Angle-Closure Glaucoma - The
`management of patients with acute angle-
`closure glaucoma requires therapeutic
`interventions in addition to ocular hypotensive
`®
`agents. AZOPT Suspension has not been
`studied in patients with acute angle-closure
`glaucoma.
`Contact Lens Wear - The preservative in
`®
`AZOPT Suspension, benzalkonium chloride,
`may be absorbed by soft contact lenses.
`Contact lenses should be removed during
`instillation, but may be reinserted 15 minutes
`after instillation.
`Adverse Reactions
`®
`In clinical studies of AZOPT Suspension, the
`most frequently reported adverse events
`reported in 5-10% of patients were blurred
`vision and bitter, sour or unusual taste. Adverse
`events occurring in 1-5% of patients were
`blepharitis,dermatitis, dry eye, foreign body
`sensation, headache, hyperemia, ocular
`discharge, ocular discomfort, ocular keratitis,
`ocular pain, ocular pruritus and rhinitis.
`Drug Interactions
`Oral Carbonic Anhydrase Inhibitors - There is a
`potential for an additive effect on the known
`systemic effects of carbonic anhydrase
`inhibition in patients receiving an oral CAI and
`®
`AZOPT Suspension. The concomitant
`®
`administration of AZOPT Suspension and oral
`CAIs is not recommended.
`High-Dose Salicylate Therapy - In patients
`treated with oral CAIs, rare instances of
`acidbase alterations have occurred with high-
`dose salicylate therapy. Therefore, the potential
`for such drug interactions should be considered
`®
`in patients receiving AZOPT Suspension.
`
`Contraindications
`®
`SIMBRINZA Suspension is contraindicated in
`patients who are hypersensitive to any
`component of this product and neonates and
`infants under the age of 2 years.
`Warnings and Precautions
`Sulfonamide Hypersensitivity Reactions -
`Brinzolamide is a sulfonamide, and although
`administered topically, is absorbed
`systemically. Sulfonamide attributable adverse
`reactions may occur. Fatalities have occurred
`due to severe reactions to sulfonamides.
`Sensitization may recur when a sulfonamide is
`readministered irrespective of the route of
`administration. If signs of serious reactions or
`hypersensitivity occur, discontinue the use of
`this preparation.
`Corneal Endothelium—There is an increased
`potential for developing corneal edema in
`patients with low endothelial cell counts.
`Severe Hepatic or Renal Impairment (CrCl <30
`®
`mL/min)— SIMBRINZA Suspension has not
`been specifically studied in these patients and
`is not recommended.
`Acute Angle-Closure Glaucoma—The
`management of patients with acute angle-
`closure glaucoma requires therapeutic
`interventions in addition to ocular hypotensive
`®
`agents. SIMBRINZA Suspension has not
`been studied in patients with acute angle-
`closure glaucoma.
`Contact Lens Wear—The preservative in
`®
`SIMBRINZA Suspension, benzalkonium
`chloride, may be absorbed by soft contact
`lenses. Contact lenses should be removed
`®
`during instillation of SIMBRINZA Suspension
`but may be reinserted 15 minutes after
`instillation.
`Severe Cardiovascular Disease—Brimonidine
`tartrate, a component of
`®
`SIMBRINZA Suspension, had a less than 5%
`mean decrease in blood pressure 2 hours after
`dosing in clinical studies; caution should be
`exercised in treating patients with severe
`cardiovascular disease.
`Potentiation of Vascular Insufficiency—
`Brimonidine tartrate, a component of
`®
`SIMBRINZA Suspension, may potentiate
`syndromes associated with vascular
`insufficiency. It should be used with caution in
`patients with depression, cerebral or coronary
`insufficiency, Raynaud’s phenomenon,
`orthostatic hypotension, or Thromboangiitis
`obliterans.
`Contamination of Topical Ophthalmic Products
`After Use—There have been reports of
`bacterial keratitis associated with the use of
`multiple-dose containers of topical ophthalmic
`products. These containers have been
`inadvertently contaminated by patients who, in
`most cases, had a concurrent corneal disease
`or a disruption of the ocular epithelial surface.
`Adverse Reactions
`SIMBRINZA Suspension
`In two clinical trials of 3 months’ duration with
`SIMBRINZA Suspension, the most frequent
`reactions associated with its use occurring in
`
`® ®
`
`drugs should be administered at least five (5)
`minutes apart.
`IMPORTANT SAFETY INFORMATION
`Warnings and Precautions
`Pigmentation - Travoprost ophthalmic solution
`has been reported to increase the pigmentation
`of the iris, periorbital tissue (eyelid) and
`eyelashes. Pigmentation is expected to
`increase as long as travoprost is administered.
`After discontinuation of travoprost,
`pigmentation of the iris is likely to be
`permanent, while pigmentation of the periorbital
`tissue and eyelash changes have been
`reported to be reversible in some patients. The
`long term effects of increased pigmentation are
`not known. While treatment with
`®
`TRAVATAN Z Solution can be continued in
`patients who develop noticeably increased iris
`pigmentation, these patients should be
`examined regularly.
`®
`Eyelash Changes - TRAVATAN Z Solution
`may gradually change eyelashes and vellus
`hair in the treated eye. These changes include
`increased length, thickness, and number of
`lashes. Eyelash changes are usually reversible
`upon discontinuation of treatment.
`Intraocular Inflammation -
`®
`TRAVATAN Z Solution should be used with
`caution in patients with active intraocular
`inflammation (e.g., uveitis) because the
`inflammation may be exacerbated.
`Macular Edema - Macular edema, including
`cystoid macular edema, has been reported
`during treatment with travoprost ophthalmic
`®
`solution. TRAVATAN Z Solution should be
`used with caution in aphakic patients, in
`pseudophakic patients with a torn posterior
`lens capsule, or in patients with known risk
`factors for macular edema.
`Angle-closure, Inflammatory or Neovascular
`®
`Glaucoma - TRAVATAN Z Solution has not
`been evaluated for the treatment of angle-
`closure, inflammatory or neovascular
`glaucoma.
`Bacterial Keratitis - There have been reports of
`bacterial keratitis associated with the use of
`multiple-dose containers of topical ophthalmic
`products. These containers had been
`inadvertently contaminated by patients who, in
`most cases, had a concurrent corneal disease
`or a disruption of the ocular epithelial.
`Use with Contact Lenses - Contact lenses
`should be removed prior to instillation of
`®
`TRAVATAN Z Solution and may be reinserted
`15 minutes following its administration.
`Adverse Reactions
`The most common adverse reaction observed
`in controlled clinical studies with
`®
`TRAVATAN Z Solution was ocular hyperemia
`which was reported in 30 to 50% of patients.
`Up to 3% of patients discontinued therapy due
`to conjunctival hyperemia. Ocular adverse
`reactions reported at an incidence of 5 to 10%
`in these clinical studies included decreased
`visual acuity, eye discomfort, foreign body
`sensation, pain and pruritus. In postmarketing
`use with prostaglandin analogs, periorbital and
`lid changes including deepening of the eyelid
`
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`
`

`

`Click here for full prescribing information
`®
`for AZOPT Suspension
`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.
`
`sulcus have been observed.
`Use in Specific Populations
`Use in pediatric patients below the age of 16
`years is not recommended because of potential
`safety concerns related to increased
`pigmentation following long-term chronic use.
`Click here for full prescribing information
`®
`for TRAVATAN Z Solution
`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.
`
`approximately 3-5% of patients in descending
`order of incidence included: blurred vision, eye
`irritation, dysgeusia (bad taste), dry mouth, and
`eye allergy. Adverse reaction rates with
`®
`SIMBRINZA Suspension were comparable to
`those of the individual components. Treatment
`discontinuation, mainly due to adverse
`reactions, was reported in 11% of
`®
`SIMBRINZA Suspension patients.
`Brinzolamide 1%
`In clinical studies of brinzolamide ophthalmic
`suspension 1%, the most frequently reported
`adverse events reported in 5-10% of patients
`were blurred vision and bitter, sour, or unusual
`taste. Adverse events occurring in 1-5% of
`patients were blepharitis, dermatitis, dry eye,
`foreign body sensation, headache, hyperemia,
`ocular discharge, ocular discomfort, ocular
`keratitis, ocular pain, ocular pruritus, and
`rhinitis.
`Brimonidine Tartrate 0.2%
`In clinical studies of brimonidine tartrate 0.2%,
`adverse events occurring in approximately 10-
`30% of the subjects, in descending order of
`incidence, included oral dryness, ocular
`hyperemia, burning and stinging, headache,
`blurring, foreign body sensation,
`fatigue/drowsiness, conjunctival follicles, ocular
`allergic reactions, and ocular pruritus.
`Events occurring in approximately 3-9% of the
`subjects, in descending order, included corneal
`staining/erosion, photophobia, eyelid erythema,
`ocular ache/pain, ocular dryness, tearing,
`upper respiratory symptoms, eyelid edema,
`conjunctival edema, dizziness, blepharitis,
`ocular irritation, gastrointestinal symptoms,
`asthenia, conjunctival blanching, abnormal
`vision, and muscular pain.
`Drug Interactions—Consider the following
`®
`when prescribing SIMBRINZA Suspension:
`Concomitant administration with oral carbonic
`anhydrase inhibitors is not recommended due
`to the potential additive effect. Use with high-
`dose salicylate may result in acid-base and
`electrolyte alterations. Use with CNS
`depressants may result in an additive or
`potentiating effect. Use with
`antihypertensives/cardiac glycosides may
`result in additive or potentiating effect on
`lowering blood pressure. Use with tricyclic
`antidepressants may blunt the hypotensive
`effect of systemic clonidine and it is unknown if
`use with this class of drugs interferes with IOP
`lowering. Use with monoamine oxidase
`inhibitors may result in increased hypotension.
`Click here for full prescribing information
`®
`for SIMBRINZA Suspension
`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.
`
`000004
`
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`

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`000005
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`000005
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