• Eligible patients with a copay (out-of-pocket expense) for a 30-day supply of Onglyza^® (saxagliptin) tablets of more than $10 can receive up to $100 in savings on either product. Offer applicable only to approved dosing as shown in US Full Prescribing Information
• Savings not applicable to monthly out-of-pocket expenses of $10 or less
• The Value Card for Onglyza must be presented along with a valid prescription for Onglyza at the time of purchase
• Offer valid for up to a total of 24 monthly fills, within 24 months, of Onglyza, as prescribed
• At the conclusion of the initial 24 months, patients will be required to re-enroll in the Program to be eligible to receive 12 additional monthly refills. Every 12 months thereafter, patients will be required to re-enroll to receive another 12 refills
• Not for concomitant use. Card is limited to 1 per patient for the life of the program and is not transferable
• Valid for residents of the U.S. and Puerto Rico. Void in Massachusetts and where prohibited by law, taxed, or restricted. Card is not valid for prescriptions covered in full or in part by a state or federally-funded program including but not limited to Medicare, Medicaid, Medigap, Veterans Administration or Department of Defense, or where the entire cost of prescription is reimbursed by a health or pharmacy benefit program
• Bristol-Myers Squibb and AstraZeneca reserve the right to discontinue or change this offer at any time without notice
• Card activation is required. First use of card must take place by 12/31/2012. Card is not an insured card

Patient Rebate Process When Using a Mail Order Pharmacy
(or if Your Retail Pharmacy Does Not Accept the Value Card):

Follow these simple steps after activating your card:

1. Call your mail order pharmacy to check if they accept value cards. If they do, provide them your value card i.d. number after they receive your prescription. You will receive the rebate when the pharmacy processes your prescription payment.
2. If they do not accept value cards:
   1. Call the phone number on your card, 1-866-747-4958 to request a patient rebate form, or go to http://www.patientrebateonline.com to download a form.
   2. When you receive your form complete and sign it. Then attach the original mail order receipt and return to the address listed on the form.
   3. Remember to keep a copy of your receipts for your records. You should receive your rebate check in about 3–4 weeks.
3. Remember, you will need to request/download a form each time you get a refill of your prescription, and complete steps 2a. & 2b. to get your rebate.

Please click here for Medication Guide, and click here for US Full Prescribing Information for ONGLYZA (saxagliptin).