Gocovri Patient assistance program
Complete a free online enrollment application to find out if you’re eligible to pay only $49 per month for your Gocovri 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 Gocovri cost savings if eligible
If you are eligible for the Gocovri 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 Gocovri through NiceRx, you will only pay $49 a month regardless of the retail price of your medication.
Am I eligible for the Gocovri patient assistance program?
You could receive your Gocovri 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 Gocovri 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 Gocovri.
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 Gocovri 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 Gocovri medication refills on your behalf for up to 1 year once you are enrolled in the program.
Is NiceRx a Gocovri coupons provider?
At NiceRx, we help eligible individuals access the Gocovri patient assistance program. This means that we are not a Gocovri coupon, a Gocovri discount card, or a Gocovri copay card provider. We do not offer any medication trial offers, or free Gocovri samples.
Can NiceRx help me get Gocovri 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 Gocovri 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 Gocovri cost without insurance?
Gocovri costs without insurance will vary depending on how much you buy and the retailer you buy it from. As a guide, Gocovri oral capsules, extended-release 68.5 mg will typically cost around $3,000 for 60 capsules. 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 Gocovri cost with insurance?
The copay of Gocovri 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 Gocovri?
Gocovri is an FDA (U.S. Food and Drug Administration) approved medication manufactured by Adamas Pharmaceuticals, Inc. Gocovri is thought to work by increasing the levels of dopamine in the brain. It has FDA approval for the treatment of dyskinesia (movement disorders) and OFF episodes in Parkinson’s disease patients receiving levodopa-based therapy, with or without concomitant dopaminergic medications.
What doses of Gocovri are available?
Gocovri is available in extended-release capsules formulation, in the following doses: 68.5 mg and 137 mg
Administer orally once daily at bedtime. The initial daily dosage is 137 mg, after 1-week increase to 274 mg. Swallow the capsule whole. You may sprinkle the contents of the capsule on soft food such as applesauce. The capsule can be taken with or without food. A reduced dose is recommended for patients with moderate or severe renal impairment.
Please read the full prescribing information and always speak with your healthcare provider for medical advice or about any changes to your dose so they can monitor and evaluate your condition.
Gocovri active ingredients
Gocovri contains amantadine as the active ingredient.
Gocovri side effects
The most common side effects of Gocovri in clinical trials compared to placebo include:
- Dry mouth
- Peripheral edema
- Orthostatic hypotension
In rare instances, Gocovri can cause more serious adverse effects. These can include:
- Sleepiness during activities of daily living
- Suicidality and depressed mood, depression, or suicidal thoughts or behavior
- Psychotic behavior
- Withdrawal-emergent hyperpyrexia and confusion – avoid sudden discontinuation
- Compulsive behaviors
Your doctor will assess the benefits of using Gocovri against your risk of side effects. Patients are encouraged to report negative side effects or adverse reactions of Gocovri to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Gocovri drug interactions
Gocovri can interact with other medications. These include:
- Other anticholinergic drugs
- Drugs affecting urinary pH – excretion increases with acidic urine, and possible accumulation with urine changes towards alkaline
- Live attenuated influenza vaccines
This list is not exhaustive and other prescription drugs may interact with Gocovri.
You should not use Gocovri if you:
- Are allergic to the active ingredient amantadine
- Are allergic to any of the other ingredients in Gocovri
- Have severe kidney disease
- Have received a “live” nasal flu vaccine within the past 14 days
- Have end-stage renal disease
- Are breastfeeding or are planning to breastfeed
Talk to your doctor about your medical condition before using Gocovri if you:
- Are taking any of the medications that could interact with Gocovri
- Have kidney disease
- Have daytime drowsiness (caused by a sleep disorder or taking certain medicines)
- Have congestive heart failure
- Have eczema
- Have glaucoma
- Have liver disease
- Suffer from seizures
- Have low blood pressure or suffer from fainting
- Have alcohol or drug addiction
- Have mental illness, psychosis, or suicidal thoughts or actions
- Are pregnant or are planning to become pregnant
Gocovri is the trademark brand name for amantadine manufactured by Adamas Pharmaceuticals, Inc. A generic version of amantadine is not available. Generic drugs are generally cheaper than brand-name drugs, but you can still find Gocovri 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.