Prescription Discounts
At Primus, we do our best to help any patient in need, so we are pleased to offer a prescription discount program that is available to everyone regardless of age, income or insurance coverage. No complicated paperwork and no enrollment fees or membership fees.

If you're paying full retail price for any prescriptions, then you need Primus Prescription Discounts card. Use this discount card any time your prescription isn't covered by insurance. It is easy and convenient to use, and the card is accepted at 9 out of 10 pharmacies nationwide.

How much can you save?
Average 20% savings on most prescriptions*
Savings are only off of the retail price, and not off of co-pay.

Can I use this discount card for other prescriptions, besides products offered by Primus?
Yes. Just present this discount card with all your prescriptions that are not covered by insurance to your pharmacist at a participating pharmacy. It is accepted at 9 out of 10 pharmacies nationwide. Better yet, use this card for your whole family.

To start saving, simply complete the form below to request a Primus Prescription Discounts card in the mail.
First Name *	Last Name *
Address *
City *	State *    Zip *
Email *	Telephone
Age
The Limbrel I am currently taking is: * (please choose one) How can I find out which one I am taking? Find it on your pharmacy label, OR look at the number imprinted on each capsule: 52001 is 250mg, 52002 is 500mg, 52005 is 250mg/50mg, and 52006 is 500mg/50mg		250mg 500mg 250mg/50mg 500mg/50mg None Yet

How did you hear about Limbrel (check all that apply)?
Physician	Physician’s Assistant	Nurse Practitioner
Pharmacist	Family Member	Friend
Internet	Advertisement	Article or Interview
Other:	(please write in)

My physician who prescribed Limbrel to me (or please contact my physician about Limbrel):
First Name		Last Name
Specialty
Address
City		State	Zip
Comments
*Required Field
* This plan is not insurance. Savings are only available at participating pharmacies. Savings may vary by prescription and by pharmacy. The program administrator may obtain fees or rebates from manufacturers and/or pharmacies based on your prescription purchases. These fees or rebates may be retained by the program administrator or shared with you and/or your pharmacy. By using this card, you agree to participate in our program in which a pharmacist may discuss safe, effective alternative prescriptions that could provide you with additional savings. Prescription claims through this program will not be eligible for reimbursement through a state Medicaid program.