*Terms and Conditions apply. See bottom of page.
This card is being provided by Amylin Pharmaceuticals, LLC to eligible patients to cover the portion of your co-pay over $25 up to a maximum of $50 off your BYDUREON prescription each month. This card will be limited to one fill per month for the duration of the program. This card should be taken along with your prescription to your pharmacy. Card activation is required. Call 1-888-206-4241 to activate your card. Please remind the pharmacist to return this card to you for use for any remaining qualifying refills.
BYDUREON Steady Savings Card
Eligible patients can start saving on their medicine as soon as the very first prescription. Simply present your activated BYDUREON Steady Savings Card to your pharmacist, and you could get up to $50 off your BYDUREON prescription each month.
To the Patient:
If your pharmacy does not accept your activated Steady Savings Card, please follow the below steps in order to receive reimbursement (if eligible)
- Call 1-888-206-4241 and request to speak to an agent
- Request a Direct Member Reimbursement (DMR) form, which will be mailed to you
- Alternately, you can visit our website www.patientrebateonline.com and follow the instructions to print out your DMR form
- Complete the form and return to the address on the form, along with a copy of this card and your pharmacy receipt indicating your purchase of BYDUREON including amount paid.
- If you are eligible, your benefit will be sent to you in the mail (this process typically takes 2-4 weeks)
Terms and Conditions: Eligible patients, whose co-pay for BYDUREON is over $25, and who present an activated Steady Savings Card, together with a valid prescription for BYDUREON at a pharmacy, can save up to $50 per month on their BYDUREON prescription; this offer is not valid for co-pays of $25 or less, and is limited to one fill per month for the duration of the program. Offer void where prohibited by law. This offer is invalid for patients whose prescription claims for BYDUREON are covered, in whole or in part, by any state or federally funded insurance program, including, but not limited to Medicare, Medicaid, Medigap, Veterans Affairs (VA) or Department of Defense (DOD) programs. Patients who move from commercial to state or federally funded prescription insurance will no longer be eligible. By accepting this offer, you agree that this offer is consistent with your insurance and that you will report the value received as may be required by your insurance provider. 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. This offer is available only in the US and PR for residents of the US and PR who are 18 years of age or older. Card must be activated before use; activation and use of the Steady Savings Card must take place by 1/31/2014; offer expires 1/31/2014. This offer is nontransferable, no substitutions are permissible, and this offer cannot be combined with any other rebate, coupon, discount, or incentive for BYDUREON. The Steady Savings Card may not be sold, purchased, traded or counterfeited; reproductions of the card are void. Amylin Pharmaceuticals, LLC reserves the right to rescind, revoke or amend this offer at any time without notice. This offer is not conditioned on any past, present or future purchase, including refills. This card has no cash value. The Steady Savings Card for BYDUREON is not insurance. By using this card, you understand and agree to comply with these terms and conditions.
Please read accompanying Full Prescribing Information and Medication Guide, including Boxed Warning for BYDUREON (exenatide extended-release for injectable suspension) 2mg.