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 $3,000 per year*
on each strength1

Eligibility Restrictions, Terms and Conditions:

*Eligible participants in the Copay Card Program ("Program") may receive annual savings up to $3,000 for Prograf® or ASTAGRAF XL®. Patients must have prescription drug coverage for Prograf® or ASTAGRAF XL®, however, this Program offer is not valid for patients whose prescription claims are reimbursed, in whole or in part, by any federal or state-government funded prescription drug benefit program (e.g., Medicare, Medicaid, Medigap, VA, DoD, TriCare, Puerto Rico Government Insurance or any state patient or pharmaceutical assistance program). Prograf patients who reside in the state of Massachusetts are not eligible to participate in the Program. The Copay Card Program is valid for twelve (12) months from date of enrollment. Annual reenrollment in the Program is required and subject to eligibility. Restrictions may apply.

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.

030-0062-PM 01/16

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