Actiq Patient assistance program
Complete a free online enrollment application to find out if you’re eligible to pay only $49 per month for your Actiq medication with our help.Get started today
- Secure: Your personal and medical information is safe with us
- Convenient: We manage the whole process and we’re here to assist you
- Ongoing refills: We request your medication refills on your behalf
NiceRx works with your healthcare provider to help you access affordable medications directly from U.S. pharmaceutical companies.
An introduction to NiceRx(01:52)
Next steps after qualifying(00:38)
Uploading documents and billing(00:50)
SSN & billing information(00:33)
Medication delivery time(00:41)
How it works
Get started by filling out the online enrollment application to find out if you are eligible.
NiceRx verifies your eligibility for medication assistance and notifies you if you are qualified. The pharmaceutical company provides your medication for free and you only pay our service fee.
You may be required to submit further information and documents required by the pharmaceutical company which can be securely uploaded online.
Your application is created and sent to your doctor for signature. At this stage, you will be billed $49 and will not be billed again until you receive your first medication delivery.
Your application is sent to the pharmaceutical company. You will be billed again once you receive your medication. We handle the entire ordering process including requesting ongoing refills.
Your monthly Actiq cost savings if eligible
If you are eligible for the Actiq patient assistance program you can receive your medication for free. Our monthly service fee of $49 per medication covers the cost of our services in applying for the program and requesting your ongoing refills on your behalf. If you obtain your Actiq through NiceRx, you will only pay $49 a month regardless of the retail price of your medication.
Am I eligible for the Actiq patient assistance program?
You could receive your Actiq without paying the full retail price if you meet the eligibility criteria for assistance. The eligibility requirements are set by the pharmaceutical companies that are providing assistance programs. At NiceRx, we review each application individually, although the main factors considered by most programs are:
- I am a permanent, legal resident of the United States or Puerto Rico
- I am uninsured or my insurance doesn’t cover my medication
- I meet certain income eligibility requirements
How do I apply for Actiq patient assistance?
We do everything that we can to take the hassle and stress out of applying for patient assistance programs. Simply start by filling in our enrollment application. We will ask for details about your healthcare provider, your insurance, and your household income. This information is required by the pharmaceutical companies you are applying to for assistance. We may also be able to help you access patient assistance for other medications that you have been prescribed, so be sure to tell us about any medications you are taking as well as Actiq.
NiceRx will review the information you have provided, and if we determine that you may be eligible for assistance, we will seek to enroll you in the Actiq patient assistance program. We will handle the enrollment process for you by working with your healthcare provider and preparing all the required paperwork for your doctor to sign. We will also request your Actiq medication refills on your behalf for up to 1 year once you are enrolled in the program.
Is NiceRx an Actiq coupons provider?
At NiceRx, we help eligible individuals access the Actiq patient assistance program. This means that we are not an Actiq coupon, an Actiq discount card, or an Actiq copay card provider. We do not offer any medication trial offers, or free Actiq samples.
Can NiceRx help me get Actiq if I have insurance?
We may be able to help you if you have insurance, including if your insurance company will not pay for your Actiq medication, or you have a high copay or coinsurance responsibility. We may even be able to assist if you do not have insurance. Please fill in our enrollment application to find out more.
How much does Actiq cost without insurance?
Actiq costs without insurance will vary depending on how much you buy and the retailer you buy it from. As a guide, Actiq oral transmucosal lozenge 200 mcg will typically cost around $2,750 for 30 lozenges. If you obtain your medication through NiceRx, you will pay a flat monthly rate of $49 per medication regardless of its retail price.
How much does Actiq cost with insurance?
The copay of Actiq will vary in line with the specific terms of your healthcare plan. For further details about what you may need to pay, your insurance provider or pharmacist will be able to calculate the copay costs with your current insurance.
What is Actiq?
Actiq is an FDA (U.S. Food and Drug Administration) approved medication manufactured by Cephalon, Inc. a subsidiary of Teva Pharmaceutical Industries. Actiq is an opioid agonist recommended for the management of episodes of breakthrough pain relief in cancer patients 16 years of age and older who are already receiving and who are tolerant to around-the-clock opioid therapy for their underlying persistent cancer pain.
Patients considered opioid-tolerant are those taking, for one week or longer, around-the-clock medicine consisting of at least 60 mg of oral morphine per day, 25 mcg of transdermal fentanyl per hour, 30 mg of oral oxycodone per day, 8 mg of oral hydromorphone per day, 25 mg oral oxymorphone per day, 60 mg oral hydrocodone per day, or an equianalgesic dose of another opioid medication. Patients must continue on around-the-clock opioids while taking Actiq.
Due to the risk of fatal respiratory depression, Actiq is contraindicated in opioid non-tolerant patients and in the management of acute or postoperative pain, including headache/migraines.
Accidental oral ingestion of Actiq, especially by children, can result in a fatal opioid overdose of fentanyl, therefore keep out of reach of children. When prescribing, do not convert patients on an mcg per mcg basis from other fentanyl products. and do not substitute with any other fentanyl products.
Actiq exposes users to risks of addiction, drug abuse, and misuse, which can lead to overdose and death. Assess patient’s risk before prescribing and monitor closely for these behaviors and conditions. Actiq is only available through a restricted program called the TIRF REMS. Pharmacies, outpatients, and healthcare professionals who prescribe to outpatients are required to enroll in the program. Patients must be opioid-tolerant to receive a TIRF medicine.
What doses of Actiq are available?
Actiq is available as a solid oral transmucosal lozenge, in the following doses: 200 mcg, 400 mcg, 600 mcg, 800 mcg, 1200 mcg, and 1600 mcg.
Please read the full medication guide and always speak with your healthcare provider about any changes to your dose so they can monitor and evaluate your condition.
Actiq active ingredients
Actiq contains fentanyl citrate as the active ingredient.
Actiq side effects
The most common side effects of fentanyl in clinical trials include:
- Nausea, dizziness
- Drowsiness, sleepiness
- Dry mouth, vomiting
- Asthenia, and headache
- Anxiety, confusion
In rare instances, Actiq can cause more serious side effects. These can include:
- Life-threatening respiratory depression (breathing problems) – monitor closely, particularly during initiation and titration
- Serotonin syndrome – potentially life-threatening
- Adrenal insufficiency
- Severe hypotension (low blood pressure)
Your doctor will assess the benefits of using Actiq against your risk of side effects. Patients are encouraged to report negative side effects or adverse reactions of Actiq to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Actiq drug interactions
Actiq can interact with other medications. These include:
- Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may cause sedation, respiratory depression, coma, and death
- Mixed agonist/antagonist and partial agonist opioid analgesics – may reduce the analgesic effect of Actiq or precipitate withdrawal symptoms
- Grapefruit or grapefruit juice
- Muscle relaxants – carisoprodol, cyclobenzaprine
- Antihistamines – cetirizine, diphenhydramine
- Azole antifungals – itraconazole, ketoconazole
- HIV protease inhibitors – nelfinavir, ritonavir
- Anticonvulsants – carbamazepine, phenytoin
This list is not exhaustive and other prescription drugs may interact with Actiq. Tell your healthcare provider about all the medications you are taking, including over-the-counter medications and other supplements.
You should not use Actiq if you:
- Are allergic to the active ingredient fentanyl citrate
- Are allergic to any of the other ingredients in the Actiq formulation
- Have acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment
- Have a known or suspected gastrointestinal obstruction, including paralytic ileus
- Have increased intracranial pressure, brain tumors, head injury, or impaired consciousness
- Have short term pain, including pain from injuries, from doctors or dentists visits, surgery, or headaches/migraines
- Are or were taking in the last 2 weeks monoamine-oxidase inhibitors
- Have severe respiratory disease, severe obstructive lung conditions, acute respiratory disease, and respiratory depression
- Have never used an opioid pain medicine
- Are pregnant or are planning to become pregnant – prolonged use of Actiq during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized
Talk to your doctor before using Actiq if you:
- Are taking any of the medications that could interact with Actiq
- Are breastfeeding or are planning to breastfeed
Actiq is the trademark brand name for fentanyl citrate manufactured by Cephalon, Inc. A generic version of fentanyl citrate is available. Generic drugs are generally cheaper than brand-name drugs, but you can still find Actiq savings through NiceRx.
*Qualifying persons may obtain medications directly from patient assistance programs without any out-of-pocket cost (or for less than $49 per medication). However, our monthly flat rate of just $49 per medication spares you the hassle of tracking down the different programs and filling out all the required paperwork for each program.
Enrollees enjoy a full-service solution, as NiceRx assists them and their physicians with the entire process. We prepare all required documents for the physician to sign, help enrollees manage all prescription refills, monitor eligibility criteria, and maintain enrollment.
**If you do not receive medications because you were determined to be ineligible for the prescription assistance by the applicable pharmaceutical companies and you have a letter of denial, we will refund any fees you paid toward medications for which you did not qualify to receive prescription assistance (“Refund”).
To receive a refund, you must send the letter of denial to us by fax to 888-517-7444, or by e-mail to [email protected] within 30 days of your receipt of such letter. The Refund is your sole and exclusive remedy for any fees you may wish to dispute.
The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.