Statutory Pricing Disclosure

Prescription Drug Name: Doptelet® (avatrombopag)
Manufacturer Name: AkaRx, Inc., a wholly-owned subsidiary of Sobi, Inc.
Wholesale Acquisition Cost (WAC) of Doptelet® (avatrombopag): $411.61 (tablet)*
Generic Prescription Drugs from the same therapeutic class (as defined by HB 19-1131): None

Colorado Prescriber WAC Disclosure
Connecticut Prescriber WAC Disclosure

*Important Notes

Pricing as of 1/1/2024, subject to change at manufacturer’s discretion. The pricing information shown above is the product’s WAC price, which represents the manufacturer’s published catalog or list price for a drug product to wholesalers as reported to third-party drug pricing publishers. The WAC price does not indicate actual transaction prices, and does not reflect any applicable discounts, rebates, or reductions in price. Pricing information listed does not imply safety or efficacy of the product.
The WAC listed does not necessarily reflect price per dosage, price per course of treatment or the cost effectiveness
Please refer to the product’s FDA-approved label and indication for further information

Discover the Doptelet Copay Program

Eligible commercially insured patients may qualify for the Doptelet Connect program

What's the program?

Eligible patients may pay as little as $0 for each Doptelet prescription

Annual maximum benefit up to $15,000

Eligible patients must:

Have commercial insurance that covers Doptelet

Not be enrolled in any state or federal healthcare program such as Medicare, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DOD), or TRICARE

Be 18 years of age or older

Be a resident in the United States or a US Territory

How to enroll:

Approved pharmacies, healthcare professionals, and Doptelet Connect can enroll patients

Patients can enroll themselves as well as their caregivers

Please call 1-833-368-2663 Monday–Friday 8am–8pm ET for more information

Terms and Conditions

Patients pay as little as $0 per prescription. Copay Program has an annual calendar cap of $15,000

The Copay Saving Program is void where prohibited by law, taxes, or restricted

This offer is non-transferable, no substitutions are permissible, and this offer cannot be combined with any other rebate/coupon, free trial, or similar offer for the specified prescription

Sobi, Inc. reserves the right to rescind, revoke, or amend this offer at any time without notice

The Patient Copay Program for Doptelet is not insurance and is not intended to substitute for insurance

Patients, pharmacists, and healthcare providers must not seek reimbursement from health insurance or any third party for any part of the benefit received by the patient through this Copay Program. Patients must not seek reimbursement from any health savings, flexible spending, or other healthcare reimbursement accounts for the amount of assistance received from the Copay Program

Certain information pertaining to your use of the Copay Program will be shared with Sobi, Inc., the sponsor of the Copay Program. The information disclosed will include the date the prescription is filled, the number of pills or product dispensed by the pharmacists, and the amount of your copay that will be paid for by using this Copay Program. For more information, please see the Sobi Privacy Policy at https://sobi-northamerica.com/privacy-policy

Acceptance in this Program is not conditioned on any past, present, or future purchase, including additional doses

Enrollment for the Copay Program is valid through the calendar year

Sobi reserves the right to change program terms at any time