*CELEBREX $4 Co-pay Card Terms and Conditions

By participating in the CELEBREX^® (celecoxib) $4 Co-pay Card program, you acknowledge that you currently meet the eligibility criteria and will comply with the terms and conditions described below:

• The Card is not valid for prescriptions that are eligible to be reimbursed, in whole or in part, by Medicaid, Medicare, or other federal or state healthcare 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”)
• The Card 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
• You must be 18 or older
• You must deduct the savings received under this program from any reimbursement request submitted to your insurance plan, either directly by you or on your behalf
• Eligible patients will pay a minimum of $4 per prescription fill. By using the Card, eligible patients will receive a savings of up to $125 per fill off their co-pay or out-of-pocket costs. The Card is good for a maximum savings of $1,750 per year ($125 per month x 14 months). The Card limits your prescription cost to $4, subject to a maximum $125 monthly benefit. Thus, if your co-pay or out-of-pocket cost is more than $129, you will save $125 off of your co-pay or total out-of-pocket costs. [Example: If your co-pay or out-of-pocket costs are $150, you will pay $25 ($150–$125=$25)]. If your co-pay or out-of-pocket costs are no more than $129, you pay $4. For a mail-order 3-month prescription, your total maximum savings will be $375 ($125x3)
• The Card is not valid for Massachusetts residents whose prescriptions are covered, in whole or in part, by third-party insurance, or where otherwise prohibited by law
• The Card cannot be combined with any other rebate/coupon, free trial, or similar offer for the specified prescription
• The Card will be accepted only at participating pharmacies
• The Card is not health insurance
• This offer is good only in the U.S. and Puerto Rico
• The Card is limited to one per person during this offering period and is not transferable
• Pfizer reserves the right to rescind, revoke, or amend this offer without notice at any time
• No membership fees
• The Card and Program expire on 12/31/18

For reimbursement when using a nonparticipating pharmacy/mail order: Pay for CELEBREX prescription and mail copy of original pharmacy receipt (cash register receipt NOT valid) with product name, date, and amount circled to: CELEBREX $4 Co-pay Card, 2250 Perimeter Park Drive, Suite 300, Morrisville, NC 27560. Be sure to include a copy of the front of your $4 Co-pay Card, your name, and mailing address.

Visit www.Celebrex.com for more information about CELEBREX. For help with the CELEBREX $4 Co-pay Card, call 1-855-612-1956, or write: CELEBREX $4 Co-pay Card, 2250 Perimeter Park Drive, Suite 300, Morrisville, NC 27560. Be sure to include your name and mailing address.