The coupon above is not health insurance. This coupon is accepted only at participating pharmacies. No membership fees apply. For any questions, please call Customer Service at 1-877-465-6437. Pfizer Inc, 235 East 42nd Street, New York, NY 10017
www.pfizer.com

How to use this NICOTROL® Inhaler coupon

If cost is a barrier for you as you are trying to quit smoking, this offer may help. NICOTROL® Inhaler may be an effective tool for you when you are ready to try to quit smoking.

1

Obtain a valid prescription for NICOTROL® Inhaler from your physician.

2

Hand the pharmacist your prescription with this coupon.

3

If eligible, pay no more than $50 for your NICOTROL® Inhaler prescription if your out-of-pocket cost is $150 or less. You will save $100 if your out-of-pocket cost is more than $150.

4

Also available on refills.

These savings are good when eligible patients present this coupon with a valid prescription for NICOTROL® Inhaler. No substitutions permitted.

Terms & Conditions

By using this coupon, you acknowledge that you currently meet the eligibility criteria and will comply with the terms and conditions described below:

  1. This coupon is not valid for prescriptions that are eligible to be reimbursed, in whole or in part, by Medicaid, Medicare or other federal or state health care programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico [formerly known as “La Reforma de Salud”]).
  2. This coupon is not valid for prescriptions that are eligible to be reimbursed by private insurance plans or other health or pharmacy benefit programs which reimburse you for the entire cost of your prescription drugs.
  3. You will pay no more than $50 if your out-of-pocket cost is $150 or less. You will save $100 if your out-of-pocket cost is more than $150.
  4. You must deduct the value of this coupon from any reimbursement request submitted to your insurance plan, either directly by you or on your behalf.
  5. This coupon cannot be combined with any other rebate/coupon, free trial or similar offer for the specified prescription.
  6. This coupon will be accepted only at participating pharmacies.
  7. This coupon is not health insurance.
  8. Offer good only in the U.S. and Puerto Rico.
  9. This coupon is limited to 1 per person during this offering period. Coupon is not transferable.
  10. Pfizer reserves the right to rescind, revoke, or amend this offering without notice.
  11. This coupon expires 12/31/2014.