We understand that even with insurance, the monthly out-of-pocket costs for your medicine can really add up. But we want you to know we’re doing something about it.
To help with prescription costs, we’re offering eligible patients the opportunity to pay as little as $25 a month for BYDUREON. All it takes is an eligible prescription and a BYDUREON SavingsRx Card.
Your savings will continue for as long as your doctor prescribes BYDUREON (within a 24-month period) and you remain eligible. Your card even saves you money when you fill your prescription through a mail-order pharmacy.
- 1. Have a valid new prescription for BYDUREON or BYDUREON Pen.
- 2. Call 1-855-292-5968 to request or activate your BYDUREON SavingsRx Card.
- 3. Retail customers: Present the activated card with your prescription to the pharmacist.
Mail-order customers: Call the number on the card and ask for Customer Service. See detailed instructions below.
We’re working to reduce your out-of-pocket prescription costs. So take advantage of the BYDUREON SavingsRx Card today. If you have any questions about the BYDUREON SavingsRx Card, call 1-855-292-5968.
*A prescription equals a 28-day supply of BYDUREON. Offer valid for up to total of 26 presciption fills within a 24-month period, as prescribed.
You may be eligible for this offer if you are insured by commercial insurance and your insurance does not cover the full cost of your prescription, or you are not insured and are responsible for the cost of your prescriptions.
- Patients who are enrolled in a state or federally funded prescription insurance program are not eligible for this offer. This includes patients enrolled in Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DOD) programs or TriCare, and patients who are Medicare eligible and enrolled in an employer-sponsored group waiver health plan or government-subsidized prescription drug benefit program for retirees.
- If you are enrolled in a state or federally funded prescription insurance program, you may not use this savings card even if you elect to be processed as an uninsured (cash paying) patient.
- This offer is not insurance and is restricted to residents of the United States and Puerto Rico. You must be 18 years of age or older.
- Eligible patients with a valid prescription for BYDUREON who present an activated Savings Card at participating pharmacies may be able to pay no more than $25 per 28-day supply for up to 24 months, subject to a maximum savings of $100 per 28-day supply. Offer not applicable to out-of-pocket expenses of $25 or less. Offer valid for up to a total of 26 refills within 24 months, as prescribed. Every year thereafter, patients will be required to renew eligibility.
- Activation and first use of the Savings Card must take place by December 31, 2015. This offer will expire on December 31, 2016.
- Patients, pharmacists, and prescribers cannot seek reimbursement from health insurance or any third party for any part of the benefit received by the patient through this offer.
- AstraZeneca reserves the right to rescind, revoke, or amend this offer at any time without notice.
- This offer is not conditioned on any past, present or future purchase, including refills.
- Offer must be presented along with a valid prescription for BYDUREON at the time of purchase.
If you use a mail-order pharmacy (or if your pharmacy does not accept the BYDUREON SavingsRx Card), activate your card and then follow the steps below:
- 1. Call your mail-order pharmacy to see if they accept the BYDUREON Savings Card. If they do, provide them with your BYDUREON SavingsRx Card number after they receive your prescription. You will receive your rebate when the pharmacy processes your prescription payment.
- 2. If your mail-order or retail pharmacy does NOT accept the BYDUREON SavingsRx Card:
- Call 1-855-292-5968 to request a patient rebate form, or go towww.patientrebateonline.comto download a form.
- When you receive your form, complete and sign it. Next, attach the original mail-order receipt and return it to the address listed on the form.
- Remember to keep a copy of your receipts for your records. You should receive your rebate check in 3 to 4 weeks.
- 3. You will need to request/download a form each time you get a refill of your prescription and complete steps 2a and 2b to receive your rebate.