You can complete the enrollment process in 3 easy steps

Step 1 Click below to submit your Savings Card ID number or to enroll without ID.

Step 2 Answer a few simple questions.

Step 3 Start using your Savings Card!

Activate your card today and save up to $200 per month on each strength1

Eligibility Restrictions, Terms and Conditions:

Eligible participants in the Copay Card Program ("Program") may receive savings of up to $200 each month for each individual prescription strength of Astagraf XL™ or Prograf. Patient is responsible for any differential over $200 for each individual prescription strength. Program offer not valid for those who participate in any federal-or state-funded prescription drug benefit program (e.g. Medicare, Medicaid, Medigap, VA, DOD, or TriCare). Savings on Prograf not valid for those patients who reside in the state of Massachusetts. The Copay Card is valid for twelve (12) months from date of enrollment. Annual reenrollment in the Program is required and subject to eligibility. Restrictions may apply.

PROGRAF: Please see the accompanying Patient Information and full Prescribing Information, including Boxed Warnings.

Astagraf XL™: Please see the accompanying Medication Guide and full Prescribing Information, including Boxed Warnings.

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.

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Prograf and Astagraf XL™ are trademarks of Astellas Pharma, Inc. © 2014 Astellas Pharma US, Inc. All Rights reserved.
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