The Onglyza™ Value Card Program

THE OFFER*

Most eligible patients with commercial prescription coverage

  • Your copay is no more than $10 per month.*

Eligible cash-paying patients*

  • Your savings are up to $100 per 30-day supply.

Sign up to receive your onglyza value card

Have you already recieved an Onglyza™ Value Card from your healthcare provider? You can activate now—it's easy!

Activate Now

*Onglyza Value Card Program Details and Eligibility

For you, the patient:

  • Eligible patients with commercial prescription coverage whose copay (out-of-pocket expense) for a 30-day supply of Onglyza (saxagliptin) is more than $10, may receive up to $100 in savings. Savings not applicable to out-of-pocket expenses of $10 or less.
  • Eligible patients without commercial prescription coverage (cash-paying patients) can receive up to $100 in savings per 30-day supply for Onglyza.
  • Any necessary step-edits or prior authorizations required by the insurance plan still apply.
  • Patients are not eligible if prescriptions are paid in part or full by any state or federally funded programs, including but not limited to Medicare or Medicaid, Medigap, VA, DOD, or Tricare. Offer not valid in Massachusetts or where prohibited by law, taxed or restricted. The Onglyza Value Card is not an insurance card.
  • First card use must take place by 5/31/2011. Limited to 1 card per patient. This card is good for savings on up to twelve 30-day supplies. Card expires 15 months from date of activation.
  • The Onglyza Value Card is accepted at participating retail pharmacies and may also be used for mail order.
  • The Onglyza Value Card must be presented along with a valid prescription for Onglyza at the time of purchase.
  • Bristol-Myers Squibb and AstraZeneca reserve the right to modify or discontinue this offer at any time.

For your pharmacist:

  • Submit transaction to McKesson Specialty Arizona Inc. using BIN #610524.
  • If primary coverage exists, input card information as secondary coverage and transmit using the COB segment of the NCPDP transaction. Applicable discounts will be displayed in the transaction response.
  • Acceptance of this card and your submission of claims for the Onglyza Value Card are subject to the LoyaltyScript® program Terms and Conditions established by McKesson Specialty Arizona Inc. By accepting this card, you agree to the LoyaltyScript® program Terms and Conditions posted at www.mckesson.com.
  • Patients are not eligible if prescriptions are paid in part or full by any state or federally funded programs, including but not limited to Medicare or Medicaid, Medigap, VA, DOD, or Tricare. Offer not valid in Massachusetts or where prohibited by law, taxed or restricted. The Onglyza Value Card is not an insurance card.
  • For questions regarding setup, claim transmission, patient eligibility or other issues, call 1-866-784-3435 (8:00 AM-8:00 PM EST, Monday-Friday).

Lost or misplaced Value Card?
A replacement is as easy as calling a customer service representative at 1-866-784-3435. Please note that if you continue to go the same pharmacy, you will not have to bring your card back to the pharmacy to continue receiving program benefits. (However, a change in pharmacies would require that you re-present your Onglyza Value Card.)


IMPORTANT INFORMATION ABOUT ONGLYZA™ (saxagliptin)

Approved Uses

ONGLYZA™ (saxagliptin) is a prescription medicine used along with diet and exercise to lower blood sugar in adults with type 2 diabetes mellitus.

ONGLYZA has not been studied with insulin.

ONGLYZA should not be used to treat people with type 1 diabetes or to treat diabetic ketoacidosis (dangerously high levels of certain acids, known as ketones, in the blood or urine).

Important Safety Information

When ONGLYZA is used with certain other diabetes medicines to treat high blood sugar, such as a sulfonylurea, low blood sugar (hypoglycemia) may occur. Symptoms of low blood sugar include shaking, hunger, sweating, headache, rapid heartbeat, change in mood, and change in vision. Follow your healthcare provider's instructions for treating low blood sugar.

If you have allergic (hypersensitivity) reactions, such as rash, hives, and swelling of the face, lips, and throat, stop taking ONGLYZA and call your healthcare provider right away.

When ONGLYZA is used with a thiazolidinedione (TZD), such as pioglitazone or rosiglitazone, to treat high blood sugar, peripheral edema (fluid retention) may become worse. If you have symptoms of peripheral edema, such as swelling of hands, feet, or ankles, call your healthcare provider.

The most common side effects with ONGLYZA include upper respiratory tract infection, urinary tract infection, and headache.

Your healthcare provider should test your blood to measure how well your kidneys work. You may need a lower dose of ONGLYZA if your kidneys are not working well.

Tell your healthcare provider if you start or stop taking other medications, including antibiotics, antifungals or HIV/AIDS medications, as your healthcare provider may need to change your dose of ONGLYZA.

Tell your healthcare provider if you are pregnant or breast-feeding, or plan to become pregnant or breast-feed.

Please see US Full Prescribing Information, including Patient Information.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Bristol-Myers Squibb and AstraZeneca do not review the information on this Web site and/or database for content, accuracy, or completeness. Use of and access to this information is subject to the terms, limitations, and conditions set by the Web site and/or database producer.

Bristol-Myers Squibb and AstraZeneca make no representation as to the accuracy or any other aspect of the information contained on such Web site and/or database, nor does Bristol-Myers Squibb or AstraZeneca necessarily endorse such Web site and/or database.

Bristol-Myers Squibb and AstraZeneca do not review the information on this Web site and/or database for content, accuracy, or completeness. Use of and access to this information is subject to the terms, limitations, and conditions set by the Web site and/or database producer.

Bristol-Myers Squibb and AstraZeneca make no representation as to the accuracy or any other aspect of the information contained on such Web site and/or database, nor does Bristol-Myers Squibb or AstraZeneca necessarily endorse such Web site and/or database.