Welcome to the activation page for the Astellas $0 Copay Program.

You can complete the activation process in 3 easy steps

Step 1

Click below to submit your Savings Card ID number or to activate without an 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. This offer is not valid for patients whose prescription claims are reimbursed, in whole or in part, by any state or federal government program, including, but not limited to, Medicaid, Medicare, Medigap, Department of Defense (DoD), Veterans Affairs (VA), TRICARE, CHAMPUS, Puerto Rico Government Health Insurance, or any State Patient or Pharmaceutical Assistance Program. This offer is void where prohibited by law. Certain rules and restrictions apply. 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.

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 registered trademarks of Astellas Pharma, Inc. © 2015 Astellas Pharma US, Inc. All Rights reserved.

030-0030-PM 04/15

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