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KOMBIGLYZE XR savings card

Get KOMBIGLYZE XR with co-pays as little as $0* for commercially insured patients. No activation required.

*Subject to eligibility. Restrictions apply. Not available for government-insured patients. Savings subject to monthly limit.

Start Saving on KOMBIGLYZE XR

Pay as little as $0* with your KOMBIGLYZE XR savings card from AZhelps

With the KOMBIGLYZE XR savings card from AZhelps, commercially insured patients can get KOMBIGLYZE XR for as little as $0 per month for as long as their doctor prescribes any available dose.

*Subject to eligibility. Restrictions apply. Not available for government-insured patients. Savings subject to monthly limit.

AZhelps is a comprehensive customer support program designed by AstraZeneca to help make managing your health easier. Your KOMBIGLYZE XR savings card from AZhelps is a convenient way for you to save at the pharmacy. Once you download your card, you can even add it to Apple Wallet or Android Pay.

Repeat these steps each time you refill your prescription to receive your check

Repeat these steps each time you refill your prescription to receive your check


ELIGIBILITY AND TERMS OF USE

ELIGIBILITY: You may be eligible for this offer if you are insured by commercial insurance and your insurance does not cover the full cost of your prescription, or you are not insured and are responsible for the cost of your prescriptions. Patients who are enrolled in a state or federally funded prescription insurance program are not eligible for this offer. This includes patients enrolled in 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. If you are enrolled in a state or federally funded prescription insurance program, you may not use this savings card even if you elect to be processed as an uninsured (cash-paying) patient. This offer is not insurance, is restricted to residents of the United States and Puerto Rico, and to patients over 18 years of age.

TERMS OF USE: Eligible commercially insured patients with a valid prescription for KOMBIGLYZE® XR (saxagliptin and metformin HCl extended-release) who present this savings card at participating pharmacies will pay $0 per 30-day supply subject to a maximum savings of $150 per 30-day supply. If you pay cash for your prescription, AstraZeneca will pay up to the first $150, and you will be responsible for any remaining balance, for each monthly prescription. Other restrictions may 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 at the time of purchase. If you have any questions regarding this offer, please call 1-855-907-3197.

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

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Download the Doctor Discussion Guide

Talk to your healthcare provider to see if KOMBIGLYZE XR is right for you.

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