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Daliresp Patient assistance program

Is your Daliresp medication too expensive? Start receiving your medication for only $49 per month.*

Complete a free online enrollment application to find out if you’re eligible to pay only $49 per month for your Daliresp medication.

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
  • 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

Play video (01:52)
  • An introduction to NiceRx
  • Next steps after qualifying
  • Uploading documents and billing
  • SSN & billing information
  • Medication delivery time

How it works

  • Apply Online

    Get started by filling out the online enrollment application to find out if you are eligible.

  • Qualification

    NiceRx verifies your eligibility for medication assistance and notifies you if you are qualified.

  • Upload Documents

    You may be required to submit further information and documents required by the pharmaceutical company which can be securely uploaded online.

  • Application Created

    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.

  • Receive Medication

    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 Daliresp cost savings if eligible

With our assistance, you could access the Daliresp patient assistance program and obtain your medication for free. We only charge a flat monthly fee of $49 per medication for our services.

Am I eligible for Daliresp patient assistance?

We review each Daliresp enrollment application individually to determine if you are eligible. Each assistance program has its own eligibility criteria and the 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 the Daliresp patient assistance program?

Our process makes it as easy as possible to apply for the Daliresp patient assistance program. Begin by completing the enrollment application form on our website.

Tell us about any medications that you are taking, including Daliresp. You must also provide details about your healthcare provider, your insurance plan and your household income. This is required by the pharmaceutical manufacturers who will supply the medication, so it is important to make sure this information is accurate and up to date.

We will review the information that you have provided to determine whether you are eligible for patient assistance. If we can pre-qualify you for assistance, NiceRx will handle the full enrollment process on your behalf. If you are approved by the pharmaceutical company, you will typically start receiving your medication in 6 – 8 weeks.

Is NiceRx a Daliresp coupons provider?

NiceRx is not a Daliresp coupon, Daliresp discount card, or Daliresp copay card provider. We do not offer Daliresp manufacturer coupons, Daliresp discounts, rebates, Daliresp savings cards, trial offers, or free Daliresp samples. We are a service provider that helps eligible individuals access the Daliresp patient assistance program.

Can NiceRx help me get Daliresp if I have insurance?

NiceRx may be able to help you get Daliresp if:

  • You have a high copay or coinsurance responsibility for Daliresp
  • Your insurance company will not pay for your Daliresp prescription
  • Your healthcare plan does not cover Daliresp medication
  • You do not have insurance

Please apply online to find out if we can help you.

How much is Daliresp with insurance?

The cost of Daliresp with insurance will depend on the terms of your healthcare plan. Your healthcare provider or pharmacist will be able to calculate your copay with your current insurance. Contact them to find out more.

How much does Daliresp cost without insurance?

Daliresp prices without insurance will vary depending on the strength of the tablets you buy (250 mcg or 500 mcg) and the pack size (20, 28, 30, or 90 tablets). Prices will also vary by retailer. As a guide, a pack of 30, 500 mcg Daliresp tablets will cost around $460.

What is Daliresp?

Daliresp is a prescription medication given to adults to treat severe chronic obstructive

pulmonary disease (COPD). It is used to slow the progression of COPD and to decrease the number of flare-ups a patient has. You take Daliresp as a tablet that must be swallowed, usually once per day. Daliresp works by reducing inflammation in your airways and lungs, helping you to breathe more easily.

Daliresp active ingredients

The active ingredient in Daliresp is roflumilast. It is a type of drug called a phosphodiesterase-4 inhibitor (PDE4 inhibitor) that reduces inflammation in your lungs and airways.

Roflumilast works by stopping your body from breaking down a substance called cyclic adenosine monophosphate (cAMP). This is a type of signaling molecule that can dampen down inflammation in your body. Roflumilast blocks an enzyme called phosphodiesterase-4 that breaks down cAMP. This stops the enzyme from working, causing levels of cAMP to rise and inflammation in your body to decrease. By reducing inflammation in your airways and lungs, roflumilast opens them up and lets you breathe in more air.

Daliresp side effects & Daliresp drug interactions

The most common side effects caused by Daliresp include:

  • Headaches
  • Dizziness
  • Back pain
  • Nausea (feeling sick)
  • Diarrhea
  • A decreased appetite
  • Weight loss
  • Problems sleeping (insomnia)
  • Flu-like symptoms

Sometimes, Daliresp can cause more serious side effects. When these occur, they can include:

  • Severe allergic reactions to the medication
  • An increased risk of mental health problems, including new or worsening anxiety and depression, and suicidal thoughts and behaviors
  • Weight loss, which can become harmful if you lose too much weight

Daliresp can interact with other medications. When this happens, it can change how Daliresp and the other medications work. Some side effects may also become more likely. These medications include:

  • Any antiviral medications taken to treat a viral infection
  • Any antiviral medications taken to treat an HIV infection, including ritonavir, atazanavir, indinavir, saquinavir, or nelfinavir
  • Any antibiotics taken to treat a bacterial infection, including rifampicin, clarithromycin, or telithromycin
  • Any antifungal medications taken to treat a fungal infection, including ketoconazole and itraconazole
  • Any anticonvulsant medications taken to reduce the chances of you having seizures, like carbamazepine, phenobarbital, or phenytoin

Daliresp warnings & precautions

Daliresp is not a bronchodilator and should not be used to treat sudden and severe onsets of symptoms (a bronchospasm). Use your rescue inhaler to treat sudden and severe symptoms, or whatever rescue medication your doctor has prescribed to you.

Daliresp is not suitable for everyone. Do not take Daliresp if you:

  • Are allergic to the active ingredient roflumilast
  • Are allergic to any of the other ingredients in Daliresp
  • Have moderate to severe liver impairment (C to D on the Child-Pugh scale)
  • Are under 18 years of age

Talk to your doctor before taking Daliresp if you:

  • Are taking any of the medications that could interact with Daliresp
  • Have a history of mood disorder or other mental health problems, particularly depression and/or suicidal thoughts and behaviors
  • Have any problems with your liver
  • Are pregnant or are planning to become pregnant
  • Are breastfeeding or are planning to breastfeed

*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.