Bydureon Pen Patient Assistance Programs

Bydureon Pen: Apply for prescription assistance below

If you are eligible, the programs below can help you afford Bydureon Pen. Review the information to see if you qualify. The applications are available in Adobe PDF format and should be mailed directly to the provider of the patient assistance program.

If you have any questions, please call the telephone number for the program (not PharmacyChecker.com) or go to the program website.

Looking for a different medication?

AZ&Me Prescription Savings Program for people with Medicare Part D

(Program 1 of 2 — Scroll down to see them all )

Provided by: AstraZeneca Pharmaceuticals
PO Box 898 Somerville, NJ 08876
TEL: 800-292-6363
Languages Spoken:
English, Spanish
Program Website
Medications
  • Bydureon Pen (exenatide synthetic)
Eligibility Requirements
  • Insurance Status May have Medicare Part D
  • Those with Part D Elibible? Required
  • Income Varies
  • Diagnosis/Medical Criteria Not specified
  • U.S. Residency Required? The patient must also be a US resident, green card or work visa holder.
Application
  • Obtaining Call, download or apply online
  • Receiving Faxed, mailed or downloaded from website
  • Returning The completed application must be faxed or mailed from the doctor's office.
  • Doctor's Action Give prescription to patient
  • Applicant's Action Complete section, sign, attach proof of income and any insurance information
  • Decision Communicated Patient notified
  • Decision Timeframe Within 2 weeks
Medication
  • Amount/Supply Up to 90 day supply
  • Sent To Doctor's office or patient's home
  • Delivery Time Within 5-7 business days
  • Refill Proces Patient or Doctor must contact company
  • Limit None
  • Re-application Must re-enroll at end of calendar year
Additional Information
Eligibility determined on a case-by-case basis. *Patients with Medicare Part B coverage may also be eligible. Contact program for details.
Updated September 27, 2018

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AZ&Me Prescription Savings Program for people without insurance

(Program 2 of 2 — Scroll down to see them all )

Provided by: AstraZeneca Pharmaceuticals
PO Box 898 Somerville, NJ 08876
TEL: 800-292-6363
Languages Spoken:
English, Spanish
Program Website
Medications
  • Bydureon Pen (exenatide synthetic)
Eligibility Requirements
  • Insurance Status Must have no prescription coverage
  • Those with Part D Elibible? No
  • Income Varies
  • Diagnosis/Medical Criteria Not specified
  • U.S. Residency Required? The patient must also be a US resident, green card or work visa holder.
Application
  • Obtaining Call, download or apply online
  • Receiving Faxed, mailed or downloaded from website
  • Returning The completed application should be faxed back from the doctor's office.
  • Doctor's Action Give prescription to patient
  • Applicant's Action Complete section, sign, attach proof of income and any insurance information
  • Decision Communicated Patient notified in writing
  • Decision Timeframe Within 2 weeks
Medication
  • Amount/Supply Up to 90 day supply
  • Sent To Doctor's office or patient's home
  • Delivery Time Within 5-7 business days
  • Refill Proces Patient or Doctor must contact company
  • Limit None
  • Re-application New application yearly
Additional Information
People who are in Medicare and may be eligible for the Limited Income Subsidy can apply. However, if they are accepted into the LIS, they are no longer eligible for the AZ& Me Prescription Savings Program. Eligibility determined on a case-by-case basis.
Updated September 27, 2018

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