HERE IS YOUR COUPON. PLEASE PRINT OR SAVE THE IMAGE.

How this coupon works:

• This coupon can be used up to 13 times before the expiration date for up to a 90-day supply of VERQUVO per qualifying prescription. Patient must pay the first $10 on each prescription. The benefit available is limited to the amount of the patient's actual out-of-pocket cost over $10, on each of up to 13 prescriptions, up to a maximum program savings of $3,500 per patient.
• Present this activated coupon and your insurance card with a valid signed prescription at any participating eligible retail or mail-order pharmacy (certain restrictions apply).
• If you are unable to redeem this coupon at your eligible retail or mail-order pharmacy, please keep your receipt and call McKesson Corporation at 877-264-2454 within 30 days of purchase to request a Direct Member Reimbursement (DMR) form. Please note: Not all patients will be eligible for Direct Member Reimbursement. Merck may discontinue Direct Member Reimbursement at any time without notice.
• If you lose this coupon, please visit verquvo-us.com to obtain a replacement coupon. Regardless of the number of replacement coupons received, this coupon offer is limited to 13 prescriptions of VERQUVO per patient before the expiration date.
• Not all patients are eligible to use this coupon. Please see Terms and Conditions.

Prescriber:

To initiate a coupon for an appropriate patient, you should:

• Read the accompanying Prescribing Information, including the boxed warning about embryo-fetal toxicity, before prescribing VERQUVO. For additional copies of the Prescribing Information, call 800-672-6372, visit verquvo-us.com, or contact your Merck representative.
• Write a prescription for VERQUVO. No substitutions are permitted.
• Give the valid signed prescription and this coupon to the patient along with the Medication Guide for VERQUVO.
• Eligible patients can take or send this coupon and the signed prescription to any participating eligible retail or mail-order pharmacy to receive savings on their out-of-pocket cost (savings will vary depending on their out-of-pocket cost).
• Not all patients are eligible to use this coupon. Please see Terms and Conditions.

Pharmacist:

• This coupon is valid only when accompanied by a prescription for VERQUVO. Coupon value may not exceed patient's actual out-of-pocket cost over $10 per prescription, on up to 13 qualifying prescriptions. Maximum program savings is $3,500 per patient. This coupon is valid for up to a 90-day supply per prescription fill. Please review Terms and Conditions on this coupon for important eligibility restrictions.
• Submit transaction to McKesson Corporation using RxBIN No. 610524. For pharmacy processing questions, please call the McKesson Help Desk at

  877-264-2454 (8 AM-8 PM ET, Monday-Friday).

• Input coupon information, including RxBIN, RxPCN, RxGrp, and ID No., as secondary coverage and transmit using the Coordination of Benefits (COB) segment of the National Council for Prescription Drug Programs (NCPDP) transaction. Applicable discounts will be displayed in the transaction response.
• Uninsured, cash-paying patients are not eligible to use this coupon. For privately insured patients without coverage for VERQUVO, you agree to charge no more than the usual and customary retail price (subject to restrictions set by McKesson). For any other prescriptions, please use the patient's primary method of payment and a new Rx number. Please clear the COB secondary screen after processing the transaction.
• Acceptance of this coupon and your submission of claims are subject to the Terms and Conditions, posted at www.mckesson.com/mprstnc, and the Terms and Conditions of this coupon.
• By processing this coupon, you agree that VERQUVO was dispensed pursuant to this coupon and that you will not submit a claim for reimbursement to any Government Program (as that term is defined in the Terms and Conditions).
• Subject to changes in state law, this coupon may become invalid for residents of Massachusetts prior to its expiration date.
• You agree to notify the patient's insurance carrier of this coupon redemption, as may be required by the terms and conditions of your relationship with the insurance carrier.
• This coupon may not be applied toward any other pharmacy purchase.
• McKesson Corporation reserves the right to audit and review all records and documentation relating to the redemption of this coupon and the dispensing of product.
• Please note: Coupon must be activated prior to the date of purchase of the prescription. Ensure the date of prescription fill matches the date the patient is actually purchasing the prescription.

Terms and Conditions:

• This coupon is valid for up to 13 qualifying prescriptions for VERQUVO. Patient is responsible for the first $10 of out-of-pocket cost on each prescription. Maximum program savings is $3,500 per patient.
• This coupon is valid for use 13 times only. Patient must have a co-payment (or, if privately insured without coverage for VERQUVO, make full cash payment) for the prescription. Savings are limited to amount of your out-of-pocket cost over $10 per prescription, for up to 13 qualifying prescriptions, up to a maximum program savings of $3,500 per patient.
• This coupon is valid for up to a 90-day supply per prescription fill.
• No other purchase is necessary.
• This coupon is not transferable. No substitutions are permitted. This offer cannot be combined with any other coupon, free trial, discount, prescription savings card, or other offer.
• This coupon is not insurance.
• Patient must have private insurance. Not valid for uninsured patients or patients covered under Medicaid (including Medicaid patients enrolled in a qualified health plan purchased through a health insurance exchange [marketplace] established by a state government or the federal government), Medicare, a Medicare Part D or Medicare Advantage plan (regardless of whether a specific prescription is covered),TRICARE, CHAMPUS, Puerto Rico Government Health Insurance Plan ("Healthcare Reform"), or any other state or federal medical or pharmaceutical benefit program or pharmaceutical assistance program (collectively, "Government Programs").
• Subject to changes in state law, this coupon may become invalid for residents of Massachusetts prior to its expiration date.
• You must be 18 years of age or older to redeem this coupon. Patient, pharmacist, and prescriber agree not to seek reimbursement for all or any part of the benefit received by the patient through this offer. Patient is responsible for reporting receipt of coupon benefit to any insurer, health plan, or other third party who pays for or reimburses any part of the prescription filled using this coupon, as may be required.
• This coupon can be used only by eligible residents of the United States or the Commonwealth of Puerto Rico at participating eligible retail or mail-order pharmacies in the United States or the Commonwealth of Puerto Rico. Product must originate in the United States or the Commonwealth of Puerto Rico.
• This coupon is the property of Merck and must be turned in on request.
• It is illegal to sell, purchase, trade, or counterfeit, or offer to sell, purchase, trade, or counterfeit this coupon. Void if reproduced. Void where prohibited by law, taxed, or restricted.
• Merck reserves the right to rescind, revoke, or amend this offer at any time without notice.
• Data related to your redemption of this coupon may be collected, analyzed, and shared with Merck, for market research and other purposes related to assessing coupon programs. Data shared with Merck will be aggregated and de-identified, meaning it will be combined with data related to other coupon redemptions and will not identify you.
• Expiration Date: 06/30/2025.