(800) 292-6363
www.azandmeapp.com

AstraZeneca has offered patient assistance programs for the past 35 years, and is committed to helping eligible patients gain access to their medications. Its AZ&Me Prescription Savings Program aims to assist a variety of patient populations.

AZ&Me Prescription Savings Program

AstraZeneca’s AZ&Me Prescription Savings Program is designed to help 3 patient groups: (1) uninsured patients, (2) beneficiaries of Medicare Part D, and (3) those who receive their medications through participating healthcare facilities (eg, community health centers and charitable pharmacies). For a complete list of oncology drugs covered through this program as well as their indications, see the Table.

Table

Eligibility
Uninsured patients and those who are beneficiaries of Medicare Part D may qualify for enrollment in the program if they meet the following eligibility requirements:

  • They must reside in the United States, or have a Green Card or US work visa
  • The patient does not have prescription drug coverage through private or government insurance programs and is not receiving any other assistance to pay for medicine
  • They meet the program’s annual income requirements (ie, at or below $35,000 for a single person; $48,000 for a family of 2; $60,000 for a family of 3; $70,000 for a family of 4; and $80,000 for a family of 5)
  • Medicare Part D beneficiaries cannot be enrolled in or eligible for Limited Income Subsidiary for Medicare Part D.
More information is available at www.azandmeapp.com/requirements.

In order to qualify for enrollment, healthcare facilities must meet several requirements, including the following:

  • There must be a licensed, outpatient pharmacy or dispensary onsite
  • They must have policies and procedures in place that are robust
  • They must hold their patients to eligibility requirements that are consistent with the program guidelines for patient eligibility (eg, patients have the necessary income requirements and are uninsured).
This program is designed to help provide AstraZeneca medicines to low-income patients through qualifying facilities, such as disproportionate share hospitals, free clinics, and charitable pharmacies. For more information, call (866) 325-8198.

Enrollment
A prescreening program is available for uninsured patients and beneficiaries of Medicare Part D at www.azandmeapp.com/eligibility/patient/medications, which determines whether the patient fulfills the basic requirements. Eligible candidates will be prompted to complete an application form, which is available at www.azandmeapp.com/assets/app.pdf. Patients are also welcome to enroll by calling (800) 292-6363 to speak with an assistance specialist. Enrollment is valid for 1 year, after which eligible patients may re-enroll. Completed enrollment forms can be faxed by a physician to (800) 961-8323 or mailed directly to the program’s PO Box.

For information about how to enroll as a healthcare facility, call (866) 325-8198. Enrollment for eligible facilities lasts 2 years, after which the establishment may re-enroll.

What Patients Will Receive
Uninsured patients/beneficiaries of Medicare Part D: Once the patient is enrolled, he or she may receive up to a 90-day supply of medication, the quantity of which is determined by the prescriber. Medications are sent to the patient’s home or to his or her physician’s office.

Refill requests can be made by calling (800) 292-6363; once the patient is enrolled in the AZ&Me Prescription Savings Program, prescriptions can be filled via this automated phone line 24 hours a day, 7 days a week.

Healthcare facilities: Eligible facilities will be able to distribute Astra­Zeneca medications to qualifying patients free of charge or for a nominal, facility-assessed fee from their outpatient pharmacy or dispensary, and may become part of a bulk replacement program.

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