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Savings Offers & Support

With all that has happened recently, it is understandable that you may need a little help. BRILINTA Patient Support Service is a FREE service for people who take BRILINTA.

Be part of a program created for you.

  • Offering a patient savings program for eligible patients
  • Helping with insurance coverage questions
  • Providing tips to help you remember to take your medication
  • Setting up refill reminders

BRILINTA Patient Support Service Get Live Help Now by calling 1-888-512-7454 Available 365 days a year, 7 AM to 9 PM ET Or, enroll here.

Helping you get BRILINTA

  • Filling your first BRILINTA prescription
  • Helping with insurance coverage questions
  • Locating a pharmacy that has BRILINTA in stock

Checking in

  • Setting up medication reminders
  • Scheduling refill reminders

Helping you save money

Start saving

With the BRILINTA FREE Trial Offer, all eligible patients will get one 30-day supply (up to 60 tablets) FREE.*

Plus, with the Savings Card,* commercially insured and cash-paying patients may save on refills.

  • Commercially insured patients: Eligible patients can save on out-of-pocket costs that exceed $18 (up to a $75 savings limit) on each 30-day supply, up to a year*
  • Cash-paying patients: Eligible patients can save up to $75 off each 30-day supply, up to a year*

Get a FREE Trial Offer card or Register a FREE Trial Offer card that you received from your doctor.

Fill your prescriptions by mail? PRINT a mail-order rebate* form.

*Subject to eligibility rules; restrictions apply.

*Free Trial Offer Eligibility

This offer is good for eligible patients purchasing up to a 30-day supply (up to 60 tablets) of BRILINTA® (ticagrelor) tablets and may not be used for any other product. This offer is good for the purchase of BRILINTA manufactured for AstraZeneca Pharmaceuticals LP and lawfully purchased from an authorized retailer or distributor in the United States or its territories. This offer may be used by eligible patients who participate in Medicaid, Medicare, or similar federal or state programs, or by patients who are Medicare eligible and enrolled in an employer-sponsored group waiver health plan or government-subsidized prescription drug benefit program for retirees. This offer may also be used by eligible patients who have commercial insurance or pay cash for their prescriptions. This offer is not insurance and is not valid for mail order, or for patients under 18 years of age. Offer not valid where prohibited by law, taxed, or restricted. Offer is not transferable, is limited to one per person, and may not be combined with any other offer. Offer must be presented along with a valid prescription for BRILINTA at the time of purchase.

For Massachusetts residents only, this offer will expire on July 1, 2015.

Medicaid or Medicare Patients: You will receive one 30-day prescription free.

Commercially Insured or Cash-Paying Patients: If you have commercial insurance, you will receive 100% off your co-pay for one 30-day prescription; if you pay cash for your prescriptions, you will receive one 30-day prescription free.

If you have any questions regarding this offer, please call 1-888-512-7454. AstraZeneca reserves the right to change or discontinue this offer at any time without notice.

Program managed by PSKW, LLC, on behalf of AstraZeneca.

Savings Card

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 and is restricted to residents of the United States and Puerto Rico and patients over 18 years of age. This offer is valid for retail prescriptions only.

TERMS OF USE:

Eligible commercially insured patients with a valid prescription for BRILINTA® (ticagrelor) tablets who present this Savings Card at participating pharmacies will pay $18 per 30-day supply, subject to a maximum savings of $75 per 30-day supply. Cash-paying patients will receive up to $75 in savings on out-of-pocket costs per 30-day supply. This offer is good for a 30-day supply, 60-day supply, or 90-day supply. This offer is good for 12 uses and each 30-day supply counts as 1 use. Other restrictions may apply. Patient is responsible for applicable taxes, if any. If you have any questions regarding this offer, please call 1-888-512-7454.

For Massachusetts residents only, this offer will expire on July 1, 2015.

Nontransferable, 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 BRILINTA at the time of purchase.

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

Program managed by PSKW, LLC, on behalf of AstraZeneca.

Mail-Order Rebate

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 rebate form even if you elect to be processed as an uninsured (cash-paying) patient.

This offer is not insurance and is restricted to residents of the United States and Puerto Rico and patients over 18 years of age. This offer is valid for retail prescriptions only. This offer is not insurance and is restricted to residents of the United States and Puerto Rico and patients over 18 years of age.

TERMS OF USE:

This offer is good for eligible patients purchasing a 90-day supply (up to 180 tablets) of BRILINTA® (ticagrelor) tablets through a mail-order pharmacy and may not be used for any other product. If you have commercial insurance for your prescriptions and your co-pay is more than $54 for a 90-day supply, you will pay the first $54 and receive up to $225 in savings from AstraZeneca. If you pay cash for your prescriptions, you will receive up to $225 in savings from AstraZeneca for a 90-day supply. This offer is good for a 90-day supply (up to 4 fills). If you have any questions regarding this offer, please call 1-888-512-7454.

For Massachusetts residents only, this offer will expire on July 1, 2015.

Nontransferable, 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 BRILINTA at the time of purchase.

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

Program managed by PSKW, LLC, on behalf of AstraZeneca.

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