To begin your 30-day free AXIRON trial, follow the directions below.

Our Promise
Now you can try AXIRON free for 30 days with the AXIRON Promise program. And, if it's not right for you,
once we confirm your eligibility, we promise to pay for one month's supply of the testosterone treatment of
your choice, as prescribed by your doctor.
To redeem this AXIRON Promise program offer, you will need your receipt from the free trial. To learn more about the
program, go to Axiron.com or call 1-877-9-AXIRON (1-877-929-4766).
See Medication Guide, including Boxed Warning, provided by the pharmacist.

This voucher is being provided to you by Lilly USA, LLC for one free trial of AXIRON (testosterone) topical solution.
This voucher is valid only in the United States and Puerto Rico. This offer may be terminated by Lilly USA, LLC at any time.
Valid for: 30-day free trial of AXIRON, as prescribed by your doctor.
Limit: One free trial of AXIRON per patient per 12-month period across all AXIRON programs.
Prescriber: Provide your patient with a new prescription for AXIRON.
Patient: Redeem at retail pharmacy.
Pharmacist: Submit Claim to OPTUMRx
For assistance, call 1-800-510-4836.
Processor requires Valid Prescriber ID #,
patient name, and DOB for claim adjudication.

RxBin# 015251
PCN# PRX2000
Group# AXRWEB
Identification# AXWB7765951
www.Axiron.com
Expires: 12/31/2013
Offer terms: Offer void where prohibited by law. Product dispensed as a trial offer pursuant to the terms of this voucher shall
not be submitted to any third-party payer, public or private (e.g., Medicaid, Medicare, private insurance, any governmental
program, or any other federal or state program such as CHAMPUS, the VA, TRICARE, or a state pharmaceutical assistance
program) for reimbursement. Offer valid in the US (and Puerto Rico, if applicable) only. This offer is not valid with any other
program, discount, or incentive involving AXIRON. It is illegal for any person to sell, purchase, or trade; or to offer to sell,
purchase, or trade; or to counterfeit this voucher. No purchase required. Use of this voucher does not create any obligation
or involve any past or future purchase requirement. Lilly USA, LLC reserves the right to rescind, revoke or amend this
program/offer without notice at any time.
You understand and agree to comply with these offer terms.
AXIRON is a registered trademark of Eli Lilly and Company.
TS85032 05/2013 2013, LILLY USA, LLC. ALL RIGHTS RESERVED.