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The ASTAGRAF XL Copay Card
With the ASTAGRAF XL Copay Card, the copay is $0.* This ASTAGRAF XL Copay Card provides your patients with savings of up to $3,000.* The ASTAGRAF XL Copay Card is valid for twelve (12) months from date of enrollment. Annual re-enrollment in the ASTAGRAF XL Copay Card Program is required.
Receiving the Card
Patients may receive the copay card in one of two ways:
1. Directly from their healthcare provider
2. Online at www.transplantmedsavings.com/extended
- Eligible patients will be able to download and print a temporary card that can be activated immediately from the website
- Subsequently, a copay card will be sent to the patient in the mail
Patients who receive their ASTAGRAF XL prescriptions by mail can also take advantage of the ASTAGRAF XL Copay Card. Patients may utilize our mail-in option by filling out the “Mail Order” card within the ASTAGRAF XL Copay Card brochure, or by visiting www.patientrebateonline.com.
Get your transplant-related questions answered with live support.
Call 1-855-TXCARES (1-855-376-8922) Monday-Friday, 9:00 am to 8:00 pm EST
*Eligible participants in the ASTAGRAF XL Copay Card Program ("Program") may receive annual savings up to $3000. Patients must have prescription drug coverage for 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). The ASTAGRAF XL 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.
ASTAGRAF XL Voucher
Limit one free trial offer per patient.
This one-time use voucher, to be presented to a retail pharmacy, is good for up to a 14-day supply of
ASTAGRAF XL at the time the initial prescription is filled. Not valid if reproduced or submitted to any other payer. Void where prohibited by law.
Eligibility restrictions, terms, and conditions
This ASTAGRAF XL 14-day free trial offer voucher (“Voucher”) is a sampling program for clinicians to provide to new patients (16 years of age or older) prescribed ASTAGRAF XL. This one-time-use Voucher is to be presented by the patient to a retail pharmacy, to redeem up to a 14-day supply of ASTAGRAF XL (“Product”), at the time the initial prescription is filled. The Voucher does not require activation or registration but must be accompanied by a valid prescription, which must be filled within 30 days of the prescription date. The offer is limited to one Voucher per patient and one benefit per Voucher. Receipt of Product is not contingent upon any past, present, or future purchases of ASTAGRAF XL or any other product.
Pharmacy and patient shall not submit (i) a claim for reimbursement for Product to any public or private third-party payer or any federal or state healthcare program; or (ii) a claim for any portion of Product to a third-party payer for purposes of counting it toward the patient’s out-of-pocket costs in any private insurance plan or federal or state healthcare program. Pharmacy will comply with all applicable state laws and any obligations, contractual or otherwise, that it has as a pharmacy provider. Patient shall not seek or accept copayment assistance from a copay foundation or otherwise for Product.
Offer good only in USA. Void where prohibited by law, taxed, or restricted. May not be used with any other discount, trial offer, or other offer. Astellas Pharma US, Inc., reserves the right to rescind, revoke, or amend this free trial offer without notice.
Support for Out-of-Pocket Expenses
Support may be available for insured patients who have trouble affording their out-of-pocket (OOP) expenses for ASTAGRAF XL. Subject to meeting eligibility requirements, patients can receive support with their expenses for prescription drugs through manufacturer-sponsored product-specific programs or through independent, health condition-oriented financial support foundations. For more information, visit Access Services for ASTAGRAF XL.