MYLERAN® Copay Savings Program

Commercially insured patients may pay as little as $10 for their MYLERAN®, now through the Waylis Patient Access and Affordability program. Terms and conditions apply. 

Commercially insured patients may pay as little as $10 for their prescription*.

*Terms and conditions apply

Get Your Copay Card:

copay card image for leukeran Myleran and tabloid. BIN #: 610600, PCN#: AS, RxGroup: 396, ID#: 39601973152

Your MYLERAN® Copay Card Information:

Provide this information to your pharmacist to save at the pharmacy.

BIN #: 610600
PCN#: AS
RxGroup: 396
ID#: 39601973152


    We care about your privacy: Waylis Therapeutics does not save or share any personal information you provide on this website. Your email address is only used to send you your savings card information and is not saved here or anywhere else. For more information, visit the privacy policy page.

    The program is for:

    • Patients with a valid prescription.
    • Patients who live in the United States, Puerto Rico, and U.S. Territories. Void where prohibited.
    • Patients with a valid commercial prescription plan.
    • Please note: This program will not work with government insurance (such as Medicaid, TRICARE, or Medicare Part D). Please select the option below for government insurance.

    Medicare / Medicaid / TRICARE

    Patients with Medicaid, Medicare, or TRICARE coverage may qualify to receive medication at very little cost or no cost or no cost at all*.   

    Please download the Patient Assistance Form before to apply and fax to 844-470-1931.

    Speak with a Care Coordinator Today

    Get Started with your Application

    en español (PDF)

    No Insurance

    Patients with no insurance coverage may qualify to receive their medication for free*. 

    Please download the Patient Assistance Form below to apply and fax to 844-470-1931.

    Speak with a Care Coordinator Today

    Get Started with your Application

    en español (PDF)

    For Healthcare Providers

    The Waylis Patient Access and Affordability  program provides two ways to help your patients save on MYLERAN® 

    Speak with a Care Coordinator Today

    Get Started with your Application

    en español (PDF)

    Copay Card Terms and Conditions:

    Offer valid for commercially insured patients who have a valid MYLERAN® prescription. No substitutions permitted.

    Not valid to individuals with Medicare Medicaid, TRICARE or any similar state or federal healthcare programs.

    Benefit limited to one use per person for any 30-day period.

    Valid only at participating pharmacies.

    This offer is non-transferable, no substitutions are permissible, and offer may not be combined with any other coupon, discount, prescription savings card, free trial, or similar offer for specified prescription.

    Federal law prohibits the selling, purchasing, trading, or counterfeiting of this Savings Card.

    Offer only valid in the United States, Puerto Rico, or other selected U.S. Territories; this offer void in California, Massachusetts or where restricted or prohibited by law.

    This offer is not conditioned on any past, present, or future purchase, including refills.

    Waylis Therapeutics reserves the right to rescind, revoke or amend the program without notice.

    Offer not applicable to co-pays of $10.00 or less.

    Eligible patients may pay as little as $10.00 for your prescription.  Annual, monthly, and per-fill program limits apply.