HOW THE PROGRAMS WORK?

 
  1. You may be contacted by a pharmacy or healthcare provider informing you that there will be an out-of-pocket cost for the product you have been prescribed.
  2. If you meet the program eligibility requirements, ask to be enrolled in the Patient Savings Program. You can also enroll yourself by contacting Access 360 at 844-ASK-A360 (1-844-275-2360).
  3. If you meet the program eligibility criteria, a Patient Savings Program account will be created for you.
  4. You will pay a set amount of your out-of-pocket costs, based on the product, and your pharmacy or healthcare provider will submit a claim to the Patient Savings Program to cover the balance, up to the program maximum. See details below.

HOW THE PROGRAMS WORK:

  1. Your patient may have an out-of-pocket cost for an AstraZeneca specialty product.
  2. If the patient meets the eligibility requirements, you can enroll him or her into the Patient Savings Program via the online enrollment portal. The links to the portal for each product are below.
  3. A Patient Savings Program account will be created for the eligible patient. Once enrolled, patient-specific account information will be presented in the portal for immediate use.
  4. The patient will pay a set amount of his or her out-of-pocket costs, based on the product. The pharmacy or provider will use the Patient Savings Program to cover the balance, up to the program maximum.

DETAILS FOR PROGRAMS

CALQUENCE (acalabrutinib) Logo
Patient pays $0 per 30-day supply, program pays remaining out-of-pocket costs up to a maximum of $26,000 per year
ENHERTU(fam-trastuzumab deruxtecan-nxki)Logo
Patient pays $0 per infusion, program pays remaining out-of-pocket costs up to a maximum of $26,000 per year. The out-of-pocket costs covered by the program can include the cost of the product itself and/or the cost of infusion of the product (program maximum of $100 per infusion assistance)* *Patients who are residents of Massachusetts, Michigan, Minnesota, or Rhode Island are not eligible for infusion assistance.
Please click here for full Prescribing Information, including Boxed WARNING for ENHERTU.
FASENRA (benralizumab) Logo
Patient pays $0 per injection, program pays remaining out-of-pocket costs up to a maximum of $13,000 per calendar year. The out-of-pocket costs covered by the program can include the cost of the product itself and/or the cost of injection administration of the product (program maximum of $100 per injection administration assistance)* *Patients who are residents of Massachusetts, Michigan, Minnesota, or Rhode Island are not eligible for injection administration assistance.
FASLODEX (fulvestrant) Logo
Patient pays $0 per dose, program pays remaining out-of-pocket costs up to a maximum of $6,000 per year
Imfinizi (durvalumab) Logo
Patient pays $0 per infusion, program pays remaining out-of-pocket costs up to a maximum of $26,000 per year. The out-of-pocket costs covered by the program can include the cost of the product itself and/or the cost of infusion of the product (program maximum of $100 per infusion assistance)* *Patients who are residents of Massachusetts, Michigan, Minnesota, or Rhode Island are not eligible for infusion assistance.
IRESSA (gefitinib) Logo
Patient pays $0 per 28-day supply, program pays remaining out-of-pocket costs up to a maximum of $26,000 per year
Patient pays $0 per 30-day supply, program pays remaining out-of-pocket costs up to a maximum of $26,000 per year
LUMOXITI (moxetumomab pasudotox-tdfk) Logo
Patient pays $0 per infusion, program pays remaining out-of-pocket costs up to a maximum of $26,000 per year. The out-of-pocket costs covered by the program can include the cost of the product itself and/or the cost of infusion of the product (program maximum of $100 per infusion assistance)* *Patients who are residents of Massachusetts, Michigan, Minnesota, or Rhode Island are not eligible for infusion assistance.
Please click here for full Prescribing Information, including Boxed WARNING for LUMOXITI.
LYNPARZA (olaparib) Tablets Logo
Patient pays $0 per 30-day supply, program pays remaining out-of-pocket costs up to a maximum of $26,000 per year
TAGRISSO (osimertinib) Logo
Patient pays $0 per 28-day supply, program pays remaining out-of-pocket costs up to a maximum of $26,000 per year