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)
Patient pays $0 per 30-day supply, program pays remaining out-of-pocket costs up to a maximum of $26,000 per year
Affordability Brochure
PATIENT ELIGIBILITY
ENROLL A PATIENT
Patient Eligibility
ENROLL A PATIENT
AFFORDABILITY BROCHURE
FASENRA™ (benralizumab)
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.
Affordability Information
PATIENT ELIGIBILITY
ENROLL A PATIENT
Patient Eligibility
ENROLL A PATIENT
AFFORDABILITY INFORMATION
FASLODEX® (fulvestrant)
Patient pays $0 per dose, program pays remaining out-of-pocket costs up to a maximum of $6,000 per year
Affordability Brochure
PATIENT ELIGIBILITY
ENROLL A PATIENT
Patient Eligibility
ENROLL A PATIENT
AFFORDABILITY BROCHURE
IMFINZI® (durvalumab)
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.
Affordability Brochure
PATIENT ELIGIBILITY
ENROLL A PATIENT
Patient Eligibility
ENROLL A PATIENT
AFFORDABILITY BROCHURE
IRESSA® (gefitinib)
Patient pays $0 per 28-day supply, program pays remaining out-of-pocket costs up to a maximum of $26,000 per year
Affordability Brochure
PATIENT ELIGIBILITY
ENROLL A PATIENT
Patient Eligibility
ENROLL A PATIENT
AFFORDABILITY BROCHURE
IMFINZI® (durvalumab)
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.
Affordability Brochure
PATIENT ELIGIBILITY
ENROLL A PATIENT
Patient Eligibility
ENROLL A PATIENT
AFFORDABILITY BROCHURE
LYNPARZA® (olaparib) Tablets
Patient pays $0 per 30-day supply, program pays remaining out-of-pocket costs up to a maximum of $26,000 per year
Affordability Brochure
PATIENT ELIGIBILITY
ENROLL A PATIENT
Patient Eligibility
ENROLL A PATIENT
AFFORDABILITY BROCHURE
SYNAGIS® (palivizumab)
Patient pays $30 per dose, program pays remaining out-of-pocket costs up to a maximum of $2,000
Affordability Brochure
PATIENT ELIGIBILITY
ENROLL A PATIENT
Patient Eligibility
ENROLL A PATIENT
AFFORDABILITY BROCHURE
TAGRISSO® (osimertinib)
Patient pays $0 per 28-day supply, program pays remaining out-of-pocket costs up to a maximum of $26,000 per year
Affordability Brochure
PATIENT ELIGIBILITY
ENROLL A PATIENT
Patient Eligibility
ENROLL A PATIENT
AFFORDABILITY BROCHURE

For questions on enrolling patients into the Patient Savings Program, AstraZeneca Access 360 serves as the primary help desk for all program questions and access needs.

For assistance, please call AstraZeneca Access 360 at 1-844-ASK-A360 (1-844-275-2360)

For questions on enrolling patients into the Patient Savings Program, AstraZeneca Access 360 serves as the primary support for all program questions and access needs.

For assistance, please call AstraZeneca Access 360 at 1-844-ASK-A360 (1-844-275-2360)