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Estimated Patient Savings $2,352,750
Program Details
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Az&me(tm) Precription Savings Program For People With Medicare Part D


Summary

AstraZeneca is a pharmaceutical company that was founded in 1999 after the merger of Astra AB and Zeneca Group PLC. Since the establishment of the company, AstraZeneca has provided solutions for cancer, heart disease, mental illness, gastrointestinal disorders, infections, and respiratory conditions. As they continue to expand, they have focused more effort on improving overall healthcare and patient treatment. AstraZeneca has their major research and development sites located in the United States, United Kingdom, Sweden, and India. As a leader in the pharmaceutical industry, AstraZeneca plans to expand even further as is evident by their acquisition of Cambridge Antibody Technology and MedImmune.

Eligibility

Patient must be enrolled in Medicare Part D, have an income at or below $30,000 as an individual or $40,000 as a couple, and patient has spent less than 3% of annual household income on outpatient prescription drugs this calendar year. Savings are based on income and patients pay no more than $25 for a typical 30-day supply of their AZ medicines. Program offers additional savings for 60- and 90-day supplies. Prescriptions can be filled at the local retail pharmacy Enrollment is for the calendar year then reapplication is required. This program is only valid for AstraZeneca medicines.


SOURCE: 2008 Poverty Chart
Family Size 100% 133% 150% 200% 250% 300%
1 $10,830 $14,404 $16,245 $21,660 $27,075 $32,490
2 $14,570 $19,378 $21,855 $29,140 $36,425 $43,710
3 $18,310 $24,352 $27,465 $36,620 $45,775 $54,930
4 $22,050 $29,327 $33,075 $44,100 $55,125 $66,150
5 $25,790 $34,301 $38,685 $51,580 $64,475 $77,370
6 $29,530 $39,275 $44,295 $59,060 $73,825 $88,590
7 $33,270 $44,249 $49,905 $66,540 $83,175 $99,810
8 $37,010 $49,223 $55,515 $74,020 $92,525 $111,030
For each additional family member $3,740 $4,974 $5,610 $7,480 $9,350 $11,220


What´s Next?

Fill out the program enrollment form located to your right. If you don’t see an enrollment form available please call AstraZeneca Pharmaceuticals program directly. After filling out the enrollment form please bring the form to your doctor for proper signatures and procedures. Do not forget a self stamped envelope for them to mail in your application to the program.


Other Tips

  • If you have any questions please call the AstraZeneca Pharmaceuticals program directly
  • Fill out as much of the information on the enrollment form as possible. The more information you have pre-filled the easier the progrm is to enroll in
  • Write down the refill dates for your program and set a reminder here on PatientAssistance.com so that you don’t run out of medication.
  • Do not write messy on your forms as this will delay any response
  • Call and write thank you notes to AstraZeneca Pharmaceuticals program. Without their help millions of people will be without medication.




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List of Medications
Accolate Tablets 10mg, 20mg (zafirlukast), Arimidex Tablets 1mg (anastrozole), Atacand Tablets 4mg,8mg, 16mg, 32mg (candesartan Cilexetil), Atacand HCT Tablets 16mg, 32mg (candesartan Cilexetil With Hydrochlorothiazide), Casodex Tablets 50mg (bicalutamide), Crestor Tablets 5mg, 10mg, 20mg, 40mg (rosuvastatin), Nexium Delayed Release Capsules 20mg, 40mg (esomeprazole), Pulmicort Flexhaler Powder For Inhalation 90mcg, 180mcg (budesonide Inhaled), Rhinocort Aqua Nasal Spray 32mcg (budesonide Nasal Spray), Seroquel Tablets 25mg, 50mg, 100mg 200mg, 300mg (quetiapine), Seroquel XR Extended Release Tablets 200mg,300mg,400mg (quetiapine Fumarate), Symbicort Inhaler 80/4.5mcg, 160/4.5mcg (budesonide/formoterol), Toprol XL Tablets 50mg, 100mg, 200mg (metoprolol), Zomig Tablets 2.5mg (zolmitriptan), Zomig Nasal Spray Nasal Spray 5mg (zolmitriptan), Zomig-Zmt Tablets 0.5mg, 2.5mg, 5mg (zolmitriptan)

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