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Pharmacy Locator Tool for SIVEXTRO® (tedizolid phosphate) tablets, 200 mg

Sign Up as a Participating Pharmacy
Sign up for the locator
Help healthcare providers looking for SIVEXTRO tablets availability find your pharmacy by signing up for the Pharmacy Locator. The locator allows healthcare providers to search for pharmacies stocking SIVEXTRO tablets within a geographic location.
Healthcare providers can access a list of pharmacies in the directory by either visiting SIVEXTRO.com or by calling 1-800-887-7002.
The directory includes the pharmacy name, address, phone numbers, and web site if provided.
This database is populated with information provided by pharmacy locations that have reported stocking SIVEXTRO tablets. The inclusion of any pharmacy location in the Merck database is not an endorsement of the pharmacy location, nor is Merck making representations or guarantees about the qualifications, competence, or skills of any pharmacy.
What do I need to do to be included in the Pharmacy Locator for SIVEXTRO tablets?
  • Provide current valid State Pharmacy License number for all pharmacy locations
  • Adhere to all applicable state or federal regulations for the administration and stocking of prescription drugs
  • Maintain a minimum of one (1) 6ct blister pack of SIVEXTRO tablets product at all times in each participating location. In the event that filling a prescription results in a participating pharmacy no longer having one 6ct blister pack in stock, the pharmacy shall restock SIVEXTRO tablets within two business days
  • Adjudicate claims for third party payors, Medicaid, and Medicare Part D for SIVEXTRO tablets
For complete details, see the Terms and Conditions for Participation in the Merck SIVEXTRO Stocking Program. The Terms and Conditions are available to review prior to enrolling. To view the Terms and Conditions, click the Next button below.
How do I begin?
Compile information on the following, which will be requested during the application process:
  • Store Pharmacy License numbers
    • Only one location is required. Multiple store entries are permitted
    • Be sure to include the exact license number, including leading zeros, in your entries
  • State of Licensure for store
  • Address details, including store name and number, address, city, state, ZIP code, phone number, fax number (if available), web site address (if available)
    • This information will be displayed on the Pharmacy Locator
  • Review and accept Terms and Conditions for Participation in the Merck SIVEXTRO Stocking Program
 
Step 1: Agree to Terms
Please read carefully the Terms and Conditions which govern inclusion on the Merck SIVEXTRO Stocking Program. You acknowledge that by clicking on the I ACCEPT check box on the next page, you intend to create an electronic signature that has the same legal force and effect as a handwritten signature and thereby indicate your acceptance on behalf of the participant of, and agreement with the Terms and Conditions for the Participation in the Merck SIVEXTRO Stocking Program (the "Terms and Conditions").
TERMS AND CONDITIONS FOR PARTICIPATION IN THE MERCK SIVEXTRO STOCKING PROGRAM
JANUARY 2016
Merck Sharp & Dohme Corp. ("Merck"), a subsidiary of Merck & Co., Inc., is pleased to provide the Merck SIVEXTRO Stocking Program (the "MSSP"). The MSSP is designed to support access to patients prescribed SIVEXTRO ® (tedizolid phosphate).
The MSSP will provide health care professionals ("HCPs") and consumers with a means of identifying community pharmacies that provide SIVEXTRO within a geographic area.
The MSSP Provides:
  • • Community pharmacies enrolled in the MSSP ("Participants") will be listed in a directory that shall be made available to HCPs and consumers. The directory is expected to be made available through a Merck web site(s). Merck may also make the information available through other means. The directory will include information provided by Participant including, but not limited to Participant’s name, address, and phone and fax numbers (if available). HCPs will be able to search or direct their patients to search for community pharmacies within their geographic location.
  • • Promotion of the MSSP Participant listing may also occur through Merck sales representatives in interested physician offices.
Enrollment Process:
The opportunity to participate in the MSSP is being made available by Merck to community pharmacies that meet the eligibility requirements defined below as determined by Merck. Enrollment in the MSSP is acquired by going through a formal approval registration with Merck that includes: 1) completing the attached registration form and agreeing in writing to the MSSP terms and conditions (the "Terms and Conditions") as set forth herein; and 2) submitting state licensure for validation by Merck for each pharmacy location that you wish to be enrolled in the MSSP.
Upon Merck’s approval of your application, you will be sent acknowledgement of your acceptance in the MSSP. Upon enrollment in the MSSP, Participants are expected to notify all eligible Participant locations of the MSSP and its requirements as soon as reasonably possible.
MSSP Eligibility Requirements:
In order to become enrolled and maintain enrollment in the MSSP, the Participant agrees to:
  1. a) Maintain a minimum of one (1) 6ct blister pack of SIVEXTRO product at all times in each participating location. In the event that filling a prescription results in a Participant no longer having one 6ct blister pack in stock, Participant shall restock SIVEXTRO within two business days.
  2. b) Make SIVEXTRO available to customers after receipt of a valid prescription order from a healthcare provider. The MSSP does not involve the purchase of SIVEXTRO from Merck. Participant is expected to purchase SIVEXTRO from its Authorized Distributor in accordance with such supplier’s terms and conditions of sale.
  3. c) Adjudicate claims and provide billing services for patients who have insurance coverage for SIVEXTRO and whose insurer or other payor provides reimbursement to the patient (including, but not limited to, third party payors, Medicare Part D, Medicaid); and
  4. d) Comply with all applicable federal, state, and local laws and regulations, including, but not limited to, the storage, handling, transportation, adverse event reporting, distribution, and administration of SIVEXTRO to consumers.
Termination:
Merck reserves the right to terminate the MSSP at any time. Merck shall provide five (5) days’ prior written notice of such termination to Participant by mail, fax, or e-mail; however, Merck reserves the right to immediately terminate Participant’s enrollment in the event of a breach of the Terms and Conditions by Participant.
Participant may terminate enrollment in the MSSP at any time upon providing Merck with written notice via email at: MSSP@merck.com . Upon receipt of such notice, Merck shall remove Participant’s contact information from all MSSP-related materials within Merck’s control and web site as soon as reasonably possible.
Changes to the Program:
Merck reserves the right to make changes to the Program in its sole discretion at any time by providing prior written notice to Participant.
Publicity:
Participant agrees not to use or reference in any advertising, sales promotion, press release, or other communication, any Merck endorsement, direct or indirect quote, code, drawing, logo, trademark, specification, or picture without the prior written consent of Merck.
Use of Participant’s Name, Logo, and Trademark:
Participant agrees to allow Merck to use Participant’s name, address, phone number, and other information Participant provides on all MSSP and related materials, including, but not limited to, MSSP-related use on Merck web sites and promotional materials related to the MSSP, without permission from Participant. Except as expressly permitted above, any additional use of Participant’s name shall require Participant’s prior written approval.
Representations and Warranties:
  1. a) Participant represents and warrants that (a) all of the information provided by Participant to enroll in the MSSP is correct and current and each Participant location will comply with the MSSP eligibility requirements set forth herein; and (b) Participant has the authority to enter into these Terms and Conditions on behalf of all pharmacy locations listed in the Participant location spreadsheet attached as Appendix 1 hereto.
  2. b) Participant and Merck represent and warrant that each shall comply with all laws, statutes, and regulations that apply to each party’s obligations hereunder.
  3. c) Participant represents and warrants that it shall act in compliance with all federal, state, and local laws, regulations, and licensing requirements, including but not limited to those applicable to patient consent, the practice of pharmacy, testing, and privacy of medical records, and medical information confidentiality.
Miscellaneous:
  1. a) Choice of Law. These Terms and Conditions shall be governed by the laws of the Commonwealth of Pennsylvania, without giving effect to Pennsylvania’s choice of law or arbitration provisions, and that the Federal and state courts therein shall have jurisdiction over the subject matter and the parties.
  2. b) Mutual Undertakings. Merck and Participant understand and agree that the mutual undertakings provided for in the Terms and Conditions for the MSSP are good and sufficient consideration for each party’s obligation hereunder.
  3. c) Adverse Events Reporting. If you become aware of an adverse event relating to a Merck pharmaceutical product, you may contact Merck at 1-800-NSC-MERCK (1-800-637-2590) to report such information.
  4. d) No Agency. Merck and Participant understand and agree that neither party is acting as an agent of the other and that neither party has the power to or shall act on behalf of or seek to bind the other party in any manner.
PARTICIPANT REGISTRATION FORM AND REQUIREMENTS
Please confirm your agreement to become a Participant in the Merck SIVEXTRO Stocking Program and acceptance of the Terms and Conditions set forth in this document by having an individual authorized to act on behalf of your organization sign below. If entering multiple pharmacy locations to be considered by Merck for participation in the Merck SIVEXTRO Stocking Program, please click the full Terms and Conditions in the link below to access the Participant Enrollment Form in Appendix 1. As instructed in the Pharmacy Locations section of the Participant Enrollment Form, please enter the location information of each pharmacy as you would like them to appear in all databases or web sites. The Participant Enrollment Form and pharmacy locations should be emailed to: MSSP@merck.com . Additionally, Participant agrees to provide written notice to Merck of any additions or deletions of locations participating in the Merck SIVEXTRO Stocking Program.
   
 
 
 
 
 
 
 
Step 2: Enter Enrollment Information
*Denotes required field
*State:
MI:
By providing the information above, Participant agrees that Merck together with the companies with whom Merck collaborates and the companies working on their behalf, may contact Participant via e-mail regarding product information, site enhancements, special offers, educational opportunities, additional resources, programs, and other product and service information about Merck. The companies working with Merck have agreed to use this information only at the direction of Merck and also have agreed not to share this information with any third parties, except as required by law. Merck will not disclose this information to anyone other than these companies, except as required by law. If Participant prefers not to receive such information about Merck products and services, Participant should call 1-800-887-7002 to request not to be contacted.
I am authorized to act on behalf of the Participant and have full legal authority to agree to the Terms and Conditions for Participation in the Merck SIVEXTRO Stocking Program.
I acknowledge that the information provided by me and the statements made by me are true and accurate and understand that falsification of the information in this application may result in the rejection of this application and/or termination as a Participant in the Merck SIVEXTRO Stocking Program.
I ACCEPT on behalf of the organization listed in this application, has/have reviewed and hereby accept the Terms and Conditions for Participation in the Merck SIVEXTRO Stocking Program, including the eligibility requirements contained therein.
Enter Electronic Signature
 
   
 
 
Step 3: Enter License Information
Enter Pharmacy State License Number and State of Licensure and click Next. You will be prompted to enter this information for each participating location.
*Denotes required field
   
 
 
Step 4: Verify Stocking Pharmacy Location and Contact Information
Location Contact should be the primary pharmacist at the location.
Pharmacy License Number: XXXX
State: XX
*Denotes required field
*State:
Contact information for stocking pharmacy
MI:
*State:
   
 
 
Review the Location Information and Associated Contact Information
Pharmacy License Number: PH21264
State: FL
3350 New Boca Raton Blvd., #A-38, Boca Raton , FL 33431
Phone:   -   -   . Fax:   . Website:   .
Type of Participant:  
Partner VSP: N/A
Contact:  
      ,    
Phone :   -   -   . Fax:   .  
Please Note: This location will be reviewed by the Merck SIVEXTRO Stocking Program Processing Center. If needed, the Processing Center will try to contact you within the next 3 to 5 business days to review your submission.
   
 
 
Before Confirming
Before you submit these locations for consideration, please be sure to review all address information, as this is how the data will appear on the Pharmacy Locator ( www.SIVEXTROPharmacyLocator.com ). Validated locations will typically be added to the Pharmacy Locator within 3 to 5 business days. If you have any questions, please contact us at 1-800-887-7002.
   
 

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