|With the MySavingsRx Card, you may be eligible to start saving TODAY!*|
How the MySavingsRx Card works
Eligible patients who activate the MySavingsRx Card may be able to start paying:
$0* for each 30-day supply of ONGLYZA® (saxagliptin) or KOMBIGLYZE™XR (saxagliptin and metformin HCI extended-release) tablets;
Just $25* for each 28-day supply of BYDUREON® (exenatide extended-release for injectable suspension), or each 30-day supply of BYETTA® (exenatide) injection, or SYMLIN® (pramlintide acetate) injection.
Start saving with these 3 simple steps
Have a prescription for one of the medications below.
Request your MySavingsRx Card (or activate one you already have) by clicking on the appropriate link above. Complete the form on the Activation Page.
Retail customers: Present activated card with your prescription to your pharmacist.
Mail Order Customers: Call the number on the card and ask for customer service, or Click here for detailed instructions.
The MySavingsRx Card for ONGLYZA® (saxagliptin), KOMBIGLYZE™ XR (saxagliptin and metformin HCI extended-release) tablets, BYDUREON® (exenatide extended-release for injectable suspension), BYETTA® (exenatide) injection, and SYMLIN® (pramlintide acetate) pen injection.
Rebate process for patients using mail order pharmacy (or if your retail pharmacy does not accept the MySavingsRx Card).
Follow these simple steps after activating your card:
Call your mail order pharmacy to see if they accept the MySavingsRx Card. If they do, provide them with your MySavingsRx ID number after they receive your prescription. You will receive your rebate when the pharmacy processes your prescription payment.
If they do NOT accept the MySavingsRx Card:
a. Call 1-855-292-5968 to request a patient rebate form, or go to www.patientrebateonline.com to download one.
b. When you receive your form, complete and sign it. Next, attach the original mail order receipt and return to the address listed on the form.
c. Remember to keep a copy of your receipts for your records. You should receive your rebate check in about 3-4 weeks.
You will need to request/download a form each time you get a refill of your prescription and complete steps 2a and 2b to get your rebate.
Please click on the product name to see the Full U.S. Prescribing information for BYDUREON® including Boxed WARNING, BYETTA®, KOMBIGLYZE™ XR including Boxed WARNING, ONGLYZA®, SYMLIN® including Boxed WARNING.
BYDUREON, BYETTA, SYMLIN, SymlinPen, and ONGLYZA are registered trademarks and
KOMBIGLYZE XR is a trademark of the AstraZeneca group of companies.
©2014 AstraZeneca. All rights reserved. 3039414 Last Updated 11/14
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