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The EOHILIA Patient Support and Copay Program

Step 1
25

Have you been prescribed EOHILIA?

Step 2
50

Would you like an EOHILIA copay card?

Step 3
75

Verify your eligibility for a copay card

*Please select an answer.

Are you a resident of the United States, Puerto Rico, or a U.S. Territory?*
Is your prescription covered, in whole or in part, under any state or federal program, including but not limited to Medicare, Medicaid, Medigap, VA, DOD, or TRICARE?*
Step 4
Step 3
Step 2
100

Tell us about yourself

Based on your previous selections you may not be eligible for the EOHILIA Patient Support and Copay Program, but there is still useful information about EOHILIA you may be interested in hearing about. Sign up to stay in the loop.

*Required field.

By choosing to enroll in Text Communications for the EOHILIA Patient Support and Copay Program, you agree to receive text messages on your mobile device subject to the Terms & Conditions here within. You also consent to receive text messages from or on behalf of EOHILIA at the telephone number provided directly by you. You understand that this consent is not a condition of purchase or use of the Program or of any Takeda product or service. You can unsubscribe from receiving text messages by texting STOP. You will remain enrolled in the EOHILIA Patient Support and Copay Program. For questions about this Program, text HELP or contact the customer support center at 1-866-861-1482. Message frequency varies. There is no fee payable to Takeda to receive text messages; however, your carrier’s message and data rates may apply. You represent that you are the account holder for the mobile telephone number(s) that you provide to opt into the Program. You are responsible for notifying Takeda immediately if you change your mobile telephone number. You may notify Takeda of a number change by calling 1-866-861-1482. Data obtained from you in connection with your registration for, and use of, this SMS service may include your phone number and/or email address, related carrier information, and elements of pharmacy claim information and will be used to administer this Program and to provide Program benefits such as information about your prescription, refill reminders, as well as Program updates and alerts. If you have any questions regarding privacy, please read Takeda's privacy notice at https://www.takeda.com/privacy-notice/ or contact us for additional information. Carriers are not liable for delayed or undelivered messages. This Program is valid with most major U.S. carriers.