HCP
Resources
Patient Assistance Programs
At AstraZeneca, we believe our responsibility goes beyond making medicine.
Through our patient assistance programs, we are making our medicines available
to those who cannot afford them. AstraZeneca has a number of different programs
to help meet your patients’ individual needs.
For details about our assistance programs and eligibility requirements, you and
your patients are encouraged to visit AZ&Me™ or click on one of the links
below.
AZ&Me is about connecting your patients with the medicine they need—even if
they can't afford it. Your patients can now complete the online form to help
determine if they may be eligible for one of the AZ&Me prescription savings
programs.
Qualifying patients without prescription coverage can use this national program
to locate public and private programs that may be right for them.
Welcome to the ZOMIG Cost Savings Program for ZOMIG. This cost-saving
program offers up to $35 off each of your patients’ prescriptions for ZOMIG, up
to 6 times within 12 months. Please tell your patients to visit patient-focused
www.ZOMIG.com to register and to also read the patient eligibility
restrictions and other terms and conditions.
Eligibility Restrictions
Your use of the ZOMIG Cost Savings Program is subject to the following terms
and conditions:
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Not valid for prescriptions purchased under Medicare, Medicaid, or similar
federal or state programs (such as medical assistance programs), or if your
insurance plan is paying the entire cost of the prescriptions
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Offer void where prohibited by law, taxed or restricted
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Residents of Massachusetts are not eligible to participate in this program
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This offer is only good for the purchase of ZOMIG manufactured for AstraZeneca
Pharmaceuticals LP and lawfully purchased from an authorized retailer or
distributor in the United States
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Offer limited to one enrollment in the ZOMIG Cost Savings Program per person
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A redemption using the ZOMIG Cost Savings Program may be made once every 30
days for a maximum of 6 prescriptions until the sooner of (i) the first
anniversary of the activation date of your ZOMIG Cost Savings Program and
(ii) the expiration date
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Each redemption using the ZOMIG Cost Savings Program may not be combined with
any other coupon, discount, prescription savings card, free trial, or other
offer
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Each of the 6 redemptions made by use of the ZOMIG Cost Savings Program is
limited to the lesser of (i) $35 per prescription, (ii) the amount of any
copay, and (iii) if you are paying the full cost of the prescription and it is
less than $35, the amount paid for the prescription
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AstraZeneca reserves the right to change or discontinue this offer at any time
without notice
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Offer expires June 30, 2009