GlaxoSmithKline - Orange Card^sm Key Facts

Eligible are:

• Senior citizens age 65 and older and the disabled enrolled in Medicare

• With annual incomes below $26,000 single / $35,000 for a couple (300% of poverty level – $25,770 single and $34,830 couple)*

• Who do not have public or private insurance coverage for prescription medicines.

Application process:

• The application is easy.

• Applicants will be asked for basic information, such as their name, mailing address, date of birth, etc., as well as annual income, and whether they already have public or private insurance coverage for prescription medicines.

• Applicants will be asked to submit their Medicare number.

• Mail in the application.

Application and program dates:

• Applications will be available November 1 through healthcare providers or by calling toll–free 1-888-ORANGE6.  We will begin taking requests for applications via this toll free number immediately, with applications mailed by November 1.

• Those eligible will receive their card within 4 weeks after their application has been received, but not before January 1, 2002.

How the savings works:

• The Orange Card is designed so participants will realize average savings of 30% off the usual price they pay for outpatient GSK medicines. In some cases, savings may be 40% or greater.**

To use the card:

• The Orange Card participant presents the Orange Card with their prescription for a GSK product to a participating pharmacy

• The patient will realize the savings at the point of sale.

Medicines covered:

• All GlaxoSmithKline outpatient products are included in the program. This list includes Advair^® (fluticasone propionate and salmeterol inhalation powder), Avandia^® (rosiglitazone maleate), Coreg^® (carvedilol), Flonase^® (fluticasone propionate), Flovent^® (fluticasone propionate), Imitrex^®(sumatriptan), Lamictal^® (lamotrigine), Lanoxin^® (digoxin), Paxil^® (paroxetine hydrochloride), Requip^® (ropinirole hydrochloride), Serevent^® (salmeterol xinafoate), Wellbutrin SR^® (bupropion hydrochloride), Zofran^® tablets (ondansetron hydrochloride) and Zyban^® (bupropion hydrochloride SR).

• GSK’s OTC products and in-patient prescription medicines are not eligible for Orange Card savings.  This would include vaccines, hospital medicines and physician administered medicines (e.g. Navelbine, Zofran IV).

*300% of the federal poverty level in Hawaii and Alaska is different and the Orange Card will accommodate these differences.

**Orange Card participants will receive direct savings on their purchase of GSK outpatient prescription drugs equal to 25% off our list price to wholesalers (as reported by First DataBank). Participating pharmacies will charge Orange Card holders no more than a negotiated price for outpatient GSK prescription drugs.  Because of variations in pharmacy prices, actual savings to Orange Card participants on each prescription will vary.  However, GSK expects participants to realize average savings of 30% off the price individuals without prescription drug coverage would usually pay for GSK medicines at their pharmacy.  In some cases, savings could be 40% or greater depending on their pharmacy's usual and customary price for the prescribed GSK medicine.

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