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Savings Your Eligible Patients Will Appreciate
As low as $0* co-pay every month for eligible commercially insured patients for as long as you prescribe FARXIGA
Get money-saving offers for your patients.
Not available for government-insured patients.
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*Eligible commercially insured patients can get FARXIGA for as low as $0 as long as their doctor prescribes it.
For Mail Order:
Call the number on the card and ask for Customer Service, or click here to download the mail-in rebate form.
Eligibility
You may be eligible for this offer if you are insured by commercial insurance and your insurance does not cover the full cost of your prescription, or you are not insured and are responsible for the cost of your prescriptions. Patients who are enrolled in a state or federally funded prescription insurance program are not eligible for this offer. This includes patients enrolled in Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DOD) programs or TriCare, and patients who are Medicare eligible and enrolled in an employer-sponsored group waiver health plan or government-subsidized prescription drug benefit program for retirees. If you are enrolled in a state or federally funded prescription insurance program, you may not use this savings card even if you elect to be processed as an uninsured (cash-paying) patient. This offer is not insurance, is restricted to residents of the United States and Puerto Rico, and to patients over 18 years of age.
Terms of use
Eligible commercially insured patients with a valid prescription for FARXIGA® (dapagliflozin) who present this savings card at participating pharmacies will pay as low as $0 per 30-day supply subject to a maximum savings of $175 per 30-day supply. If you pay cash for your prescription, AstraZeneca will pay up to the first $150, and you will be responsible for any remaining balance, for each monthly prescription. Other restrictions may apply. Patient is responsible for applicable taxes, if any. Non-transferable, limited to one per person, cannot be combined with any other offer. Void where prohibited by law, taxed or restricted. Patients, pharmacists, and prescribers cannot seek reimbursem*nt from health insurance or any third party for any part of the benefit received by the patient through this offer. AstraZeneca reserves the right to rescind, revoke, or amend this offer, eligibility and terms of use at any time without notice. This offer is not conditioned on any past, present or future purchase, including refills. Offer must be presented along with a valid prescription at the time of purchase.
If you have any questions regarding this offer, please call 1-844-631-3978.
BY USING THIS CARD, YOU AND YOUR PHARMACIST UNDERSTAND AND AGREE TO COMPLY WITH THESE ELIGIBILITY REQUIREMENTS AND TERMS OF USE.
FARXIGA Is Covered for the Majority of Patients1
Find out if FARXIGA is covered for your patients
FARXIGA is covered without prior authorization for the majority of Commercial and Medicare Part D patients.1,* By using the tool below when you write a prescription for FARXIGA, you may be able to get helpful information about coverage, as well as co-pay information.
Formulary Finder
To see formulary coverage for your patients, view access by state.
Please select a state and county (optional) to find formulary information for FARXIGA. You can review tier status and managed care coverage for commercial, Medicare, and Medicaid plans.
SELECTED PLANS FOR FARXIGA® (dapagliflozin):
Try Later
Individual costs and benefit design may vary. Please consult with individual plans for specific information.
AstraZeneca does not endorse any individual, commercial, Medicare Part D, or Medicaid plan or plans.
Source: Fingertip Formulary® Database. Sept. 30, 2023.
Tier 1 = lowest co-pay; Tier 2 = middle-level co-pay (preferred); Tiers 3-7 = higher-level co-pay (non-preferred); For Medicare Part D plans, ‘Preferred - Tier 3’ refers to the lowest co-pay level for branded products; NC = not covered; NA = data not available; PA = prior authorization; QL = quantity limits; ST = step therapy; OR = other restrictions.
Plan Type:
State:
View tier and restriction key
Individual costs and benefit design may vary. Please consult with individual plans for specific information.
AstraZeneca does not endorse any individual, commercial, Medicare Part D, or Medicaid plan or plans.
Source: Fingertip Formulary® Database. Abbreviated month name day, year.
Tier Classifications:
Tier 1 = lowest co-pay
Tier 2 = middle-level co-pay (preferred)
Tiers 3-7 = higher-level co-pay (non-preferred)
For Medicare Part D plans, 'Preferred - Tier 3' refers to the lowest co-pay level for branded products;
Restrictions:
NC = not covered
NA = data not available
PA = prior authorization
QL = quantity limits
ST = step therapy
OR = other restrictions
Please select the type of plan you're looking for:
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