Support

FASENRA
Savings Program

Start, Stay, and Save with FASENRA.

100%

of commercial patients have access to FASENRA*

Patients who are denied by their insurance have access to FASENRA through the Denied Patient Savings Program

*As of November 26, 2018. “Access” for commercial patients is defined as formal coverage for FASENRA under a medical benefit or access to FASENRA at no cost through an available patient support program.

“Patients” means covered lives (Commercial, Commercial [BCBS], Employer, Federal Program, FEHBP, Municipal Plan, PBM, Union) at Tiers 1–7 in the nation, as calculated by Fingertip Formulary® as of November 26, 2018.

If FASENRA is approved

If FASENRA is approved by insurance, eligible patients may pay as little as $0 for FASENRA and its injection administration or injection training.

To be eligible, patients must have:

  • Commercial insurance
  • FASENRA approved by their insurance plan

Up to $13,000 per year for both drug and injection administration. To view full eligibility requirements and terms of use for covered and denied patients, please visit www.fasenrahcp.com or call 1-833-360-HELP (1-833-360-4357).

If FASENRA is denied

FASENRA is the only biologic for severe eosinophilic asthma that offers up to 2 years of treatment with FASENRA Prefilled Syringe or FASENRA Pen at no cost to patients§

To be eligible, patients must have:

  • Valid prescription for on-label use
  • Commercial insurance
  • Denied PA and denied PA appeal

§Enrollment is open through December 31, 2021. Patients who enroll receive support up to 24 months from the date of initial prescription. Individual costs and benefit design may vary by plan. Please consult with individual plans for specific information. AstraZeneca does not endorse any individual, Commercial, Medicare Part D, or Medicaid plan or plans.

HOW THE FASENRA ELIGIBILITY PROGRAM WORKS

The FASENRA Savings Program helps eligible commercially insured patients receive FASENRA for as little as $0 out-of-pocket for the medication and its injection administration. State restrictions apply. Your role in the program will vary, depending on how your practice acquires FASENRA.

01

Specialty
Pharmacy

If acquiring FASENRA through a Specialty Pharmacy:

Out-of-pocket costs for FASENRA:

Patients can sign up for the FASENRA Savings Program by signing the Support Program section of the AstraZeneca Access 360TM Enrollment Form.

Download Enrollment Form

Out-of-pocket costs for injection administration:

Patients are responsible for requesting reimbursement for out-of-pocket costs for injection administration and education.

Download Reimbursement Form

02

Buy & Bill

If buying FASENRA from a Specialty Distributor to administer to your patients:

Create an account at fasenrasavings.com
Create an account at fasenrasavings.com

01

Create

an account online at www.FasenraSavings.com

Call Access 360 at 1-833-360-4357
Call Access 360 at 1-833-360-4357

02

Call

Access 360 at 1-833-360-4357 to learn about how to use the FASENRA Patient Savings Program

Enroll - Eligible Patients at fasenrasavings.com
Enroll - Eligible Patients at fasenrasavings.com

03

Enroll

eligible patients at www.FasenraSavings.com

It is highly recommended that you enroll your patients AFTER the PA is approved

FASENRA Savings Program Support
FASENRA Savings Program Support

03

Denied Patients

If a patient with commercial insurance has a FASENRA prescription for on-label use and their PA appeal has been denied by their insurance plan,

FASENRA may be available at no cost through the Denied Patient Savings Program.

To enroll a patient in the FASENRA Savings Program for Denied Patients:

01Patients in this program will receive FASENRA from Diplomat Specialty Pharmacy

02You will be notified that the information has been received within 2 business days

03While the out-of-pocket costs for patients will vary, most eligible patients may pay as little as $0 per injection of FASENRA

FASENRA could be as low as $0||

||Up to $13,000 per year for both drug and injection administration. To view full eligibility requirements and terms of use for covered and denied patients, see below.

BRANDI | REAL FASENRA PATIENT

FASENRA Savings Program Full Eligibility & Terms of Use

Eligibility

Patients may be eligible for this offer with the following criteria:

Patients who are enrolled in a state- or federally funded prescription insurance program are not eligible for this offer. This includes patients who are enrolled in Medicare Part B, Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DoD) programs or TriCare, and patients who are Medicare eligible and enrolled in an employer-sponsored group waiver health plan or government-subsidized prescription drug benefit program for retirees. Patients who are enrolled in a state- or federally funded prescription program may not use this program even if they elect to be processed as uninsured (cash-paying). This offer is not insurance.

Terms of Use

Eligible commercially insured patients with a valid prescription for FASENRA who enroll in this program may pay as little as $0 per administration of FASENRA dependent upon patient’s prescription coverage of FASENRA.

FASENRA Savings Program – If FASENRA is covered by the health plan:

Other restrictions apply. Patient is responsible for applicable taxes, if any. Non-transferable, limited to one per person, cannot be combined with any other offer. Void where prohibited by law, taxed, or restricted. Patients, pharmacists, and prescribers cannot seek reimbursement from health insurance or any third party for any part of the benefit received by the patient through this offer. AstraZeneca reserves the right to rescind, revoke, or amend this offer, eligibility, and terms of use at any time without notice. This offer is not conditioned on any past, present, or future purchase, including refills. Offer must be presented along with a valid prescription for FASENRA at the time of purchase. Program covers the cost of the drug, injection administration, and injection training,*,† and does not cover the costs for office visits or any other associated costs.

If you meet the Copay Savings program eligibility criteria but FASENRA is not covered by your health plan, you may qualify for the Denied Patient Savings Program.

Denied Patient Savings Program Eligibility: Patient must meet all savings program eligibility criteria in addition to the following criteria:

Terms of Use

Denied Patient Savings Program – If FASENRA is NOT covered by the health plan:

BY USING THIS PROGRAM, YOU AND YOUR PHARMACIST AND/OR PHYSICIAN UNDERSTAND AND AGREE TO COMPLY WITH THESE ELIGIBILITY REQUIREMENTS AND TERMS OF USE.

*Patients are responsible for any cost associated with the injection administration or injection training above the $100 per injection administration and injection training assistance provided by the program.

Patients who are residents of Massachusetts, Michigan, Minnesota, or Rhode Island are not eligible for injection administration or injection training assistance.

IMPORTANT SAFETY INFORMATION