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Helping uninsured patients get their AstraZeneca medicines AZ&Me™ Prescription Savings program for healthcare facilities What is it? • Outpatient-based program for free clinics, community health centers, disproportionate share hospitals, and central-fill and charitable pharmacies to obtain AstraZeneca medicines at no cost for patients who qualify • Bulk replacement program based on facility’s qualifying product utilization
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Who is eligible? • Nonprofit facilities that have an on-site, outpatient, licensed pharmacy or dispensary • Eligible facilities provide product to qualifying patients who do not have prescription coverage • Eligible facilities provide product to patients who have an annual income at or below $30,000/individual, $40,000/couple, or $60,000/family of four
What medicines are included? ACCOLATE® (zafirlukast) Tablets
SEROQUEL® (quetiapine fumarate)
ARIMIDEX (anastrozole)
SEROQUEL XR® (quetiapine fumarate) Extended-Release Tablets
ATACAND® (candesartan cilexetil)
SYMBICORT® (budesonide/formoterol fumarate dihydrate) Inhalation Aerosol
®
ATACAND HCT® (candesartan cilexetil-hydrochlorothiazide) CASODEX® (bicalutamide) CRESTOR® (rosuvastatin calcium) FASLODEX® (fulvestrant) Injection NEXIUM (esomeprazole magnesium) ®
PULMICORT FLEXHALER™ ( budesonide inhalation powder, 90 mcg & 180 mcg) PULMICORT RESPULES® ( budesonide inhalation suspension) RHINOCORT AQUA® (budesonide)
TOPROL-XL® (metoprolol succinate) ZOLADEX® (goserelin acetate implant) ZOMIG® (zolmitriptan) ZOMIG® (zolmitriptan) Nasal Spray ZOMIG-ZMT® (zolmitriptan) * Other AstraZeneca medicines may also be available. Program eligibility criteria, products covered, and cost of products subject to change.
Full Prescribing Information is available at www.astrazeneca-us.com, or by calling AstraZeneca at 1-800-236-9933. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch, or call 1-800-FDA-1088.
For more information 1-800-AZandMe (1-800-292-6363) or AZandMe.com AZ&ME and PULMICORT FLEXHALER are trademarks and ACCOLATE, ARIMIDEX, ATACAND, ATACAND HCT, CASODEX, CRESTOR, NEXIUM, PULMICORT RESPULES, RHINOCORT AQUA, SEROQUEL, SEROQUEL XR, SYMBICORT, TOPROL-XL, ZOLADEX, ZOMIG, and ZOMIG-ZMT are registered trademarks of the AstraZeneca group of companies. ©2010 AstraZeneca LP. All rights reserved. 283798 7/09
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Prescription Savings Programs
May / June 2 0 1 0 D e l a w a r e B u s i n e s s
5/12/10 4:06 PM