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 Savings Card. If they do, provide them with your Savings Card ID number after they receive your prescription. You will receive your check when the pharmacy processes your prescription payment.
If your mail order or retail pharmacy does NOT accept the Savings Card:
A. Call 1-844-381-6301 to request a patient rebate form, or go to www.MySavingsRx.com/rebate to download a form.
B. When you receive this form, complete and sign it. Then mail this form along with the original mail-order pharmacy receipt (cash register receipts are not acceptable) to the address listed on the form. Forms submitted without the original mail-order pharmacy receipt will not be valid and therefore will not be eligible for reimbursement.
C. Remember to keep a copy of your receipts for your records. You should receive your check in about 6 to 8 weeks.
You will need to submit a patient rebate form each time you get a refill of your prescription and complete step 2B to receive your check.
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, KOMBIGLYZE XR, ONGLYZA, SYMLIN and SYMLINPEN are registered trademarks of the AstraZeneca group of companies.
©2015 AstraZeneca. All rights reserved. 1916808-3143740 Last Updated 8/15
Based on the medicine your doctor prescribes, you may be able to:
PAY AS LITTLE AS $0* FOR
(save up to $150 per month)
PAY JUST $25* FOR
for as long as your doctor prescribes
Not available for government-insured patients.