The AZ&Me™ Prescription Savings program for people without insurance is designed to provide AstraZeneca medicines at no cost to qualified patients. This patient prescription assistance program can help patients who do not have prescription drug coverage and who meet other eligibility criteria.

How to Apply

Please either download the application below (if available) or go to the program website for more information on how to apply. Once you fill out your application, send it to the address on the application. Remember not to send program applications to the PPA.

Product(s) Covered by Program

  • A

    • ARIMIDEX® (anastrozole) Tablets
  • B

    • BRILINTA® (ticagrelor) Tablets
    • BYDUREON® (exenatide extended-release for injectable suspension)
    • BYETTA® (exenatide) Injection
  • C

    • CAPRELSA® (vandetanib) Tablets
    • CRESTOR® (rosuvastatin calcium) Tablets
  • F

    • FARXIGA® (dapagliflozin) Tablets
    • FASLODEX® (fulvestrant) Injection
  • K

    • KOMBIGLYZE® XR (saxagliptin and metformin hydrochloride extended-release) Tablets
  • L

    • LYNPARZA™ (olaparib) Capsules
  • M

    • MERREM® I.V. (meropenem for injection)
    • MOVANTIK™ (naloxegol) Tablets
    • MYALEPT™ (metreleptin) for Injection
  • N

    • NEXIUM® (esomeprazole magnesium) Delayed Release Capsules
    • NEXIUM® (esomeprazole magnesium) for Oral Suspension
    • NEXIUM® (esomeprazole sodium) for Injection
  • O

    • ONGLYZA® (saxagliptin) Tablets
  • P

    • PULMICORT FLEXHALER® (budesonide inhalation powder)
    • PULMICORT RESPULES® (budesonide inhalation suspension)
    • PULMICORT® Turbuhaler (budesonide inhalation powde)
  • S

    • SEROQUEL XR® (quetiapine fumarate) Extended Release Tablets
    • SYMBICORT® (budesonide/formoterol fumarate dihydrate) Inhalation Aerosol
    • SYMLIN® (pramlintide acetate) Injection
  • X

    • XIGDUO™ XR (dapagliflozin and metformin hydrochloride extended-release) Tablets
  • Z

    • ZOLADEX® (goserelin acetate implant) 1 month 3.6 mg
    • ZOLADEX® (goserelin acetate implant) 3 month 10.8 mg