For eligible commercially insured patients:
You can start saving now with the SYMBICORT $25 Guarantee Program.† New and current eligible commercially insured patients pay no more than $25 for each fill, up to 12 fills, with the savings card, including those with restrictions on prescription benefit coverage.† New patients may also be eligible to receive their first fill free.
To receive the SYMBICORT $25 Guarantee Program† offer and SYMBICORT information, register below.
For Medicare/Medicaid/Cash-paying patients:
You may be eligible to receive your first SYMBICORT prescription (one inhaler) absolutely free.† Present the free prescription offer to your pharmacist, along with a valid prescription for SYMBICORT.
To receive the SYMBICORT Free Prescription offer and SYMBICORT information, register below.
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SYMBICORT SAVINGS PROGRAM 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 12 years of age. This offer is not valid for mail order.
Eligible commercially insured patients with a valid prescription for SYMBICORT® (budesonide/formoterol fumarate dihydrate) who present this savings card at participating pharmacies will pay $25 per 30 day supply (1 inhaler) if their out-of-pocket cost is more than $25. New commercially insured patients will receive 100% off their out-of-pocket cost for the first inhaler. If you pay cash for your prescription, you will receive up to $100 in savings on your out-of-pocket costs that exceed $25 for each prescription. This offer is good for 12 uses and each inhaler counts as 1 use. Other restrictions may apply. Patient is responsible for applicable taxes, if any. Card expires on 12/31/2015. If you have any questions regarding this offer, please call [1-866-421-2848].
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.
If your commercial insurance plan does not cover SYMBICORT, use of this offer permits your health care provider or pharmacy to share limited information with certain AstraZeneca vendors to determine if additional resources may be available to you; and to act on your behalf to initiate any processes that may be necessary to access these resources.
SYMBICORT contains formoterol, a long-acting beta2-adrenergic agonist (LABA). LABA medicines such as formoterol increase the risk of death from asthma problems. It is not known whether budesonide, the other medicine in SYMBICORT, reduces the risk of death from asthma problems seen with formoterol.
SYMBICORT does not replace rescue inhalers for sudden asthma symptoms.
Be sure to tell your health care provider about all your health conditions, including heart conditions or high blood pressure, and all medicines you may be taking. Some patients taking SYMBICORT may experience increased blood pressure, heart rate, or change in heart rhythm.
Do not use SYMBICORT more often than prescribed. While taking SYMBICORT, never use another medicine containing a LABA for any reason. Ask your health care provider or pharmacist if any of your other medicines are LABA medicines.
SYMBICORT can cause serious side effects, including:
Approved Uses for SYMBICORT
SYMBICORT 160/4.5 is for adults with COPD, including chronic bronchitis and emphysema. You should only take 2 inhalations of SYMBICORT twice a day. Higher doses will not provide additional benefits.
Please see full Prescribing Information and Medication Guide and discuss with your doctor.
Talk to your doctor about prescription SYMBICORT.
Read Prescribing Information, including Boxed WARNING, with Medication Guide (PDF — 551 KB).
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch or call 1-800-FDA-1088.
This site is intended for US consumers only.
The information on this Web site should not take the place of talking with your doctor or health care professional. If you have any questions about your condition, or if you would like more information about SYMBICORT, asthma, or COPD, talk to your doctor or pharmacist. Only you and your doctor can decide if SYMBICORT is right for you.