Eligible patients pay as little as

Zero Dollar
Zero Dollar

With BREZTRI Zero Pay, your monthly cost for BREZTRI could be as low as $0*. If you have commercial insurance, you may be eligible. Commercial insurance is sometimes referred to as "private insurance" and is typically provided by the company you work for.

*For eligible commercially insured patients only. Subject to applicable insurance plan’s eligibility rules and requirements; restrictions may apply.

BREZTRI Zero Pay
BREZTRI Zero Pay

BREZTRI Zero Pay makes it easy to save. Simply enter your information below and have the savings card sent right to your phone. That way, all you have to do is bring your phone to the pharmacy and you’re all set.

See the BREZTRI Prescribing Information here

*BREZTRI Zero Pay Terms and Conditions

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 and is restricted to residents of the United States and Puerto Rico. If you use a mail-order pharmacy, please contact your pharmacy provider to confirm if this offer will be accepted.

TERMS OF USE: Eligible commercially insured/covered patients with no restrictions (step-edit, prior authorization, or NDC block) and a valid prescription for BREZTRI AEROSPHERETM (budesonide, glycopyrrolate, and formoterol fumarate) Inhalation Aerosol who present this savings card at participating pharmacies will pay as low as $0 for each 30-day supply (1 inhaler), subject to a maximum savings limit; patient out-of-pocket expenses may vary. If you are insured and your insurance does not cover or has a managed care restriction on your prescription (step-edit, prior authorization, or NDC block), you will pay as low as $40 for each 30-day supply (1 inhaler), subject to a maximum savings limit of $594.68 per 30-day supply (1 inhaler). If you pay cash for your prescription, AstraZeneca will pay up to the first $100, and you will be responsible for any remaining balance, for each monthly prescription. This offer is good for 12 uses and each inhaler counts as 1 use. 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 reimbursement 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. Maximum savings limit applies. For additional details about this offer, please visit www.breztrisavings.com. If you have any questions regarding this offer, please call 1-833-458-0440.

BY USING THIS CARD, YOU AND YOUR PHARMACIST UNDERSTAND AND AGREE TO COMPLY WITH THESE ELIGIBILITY REQUIREMENTS AND TERMS OF USE.

Pharmacist Instructions for a Patient With an Eligible Third Party Payer:
For Insured/Covered Patients: Submit the claim to the primary Third-Party Payer first, then submit the balance due to Change Healthcare as a Secondary Payer COB with patient responsibility amount and a valid Other Coverage Code of 8. This will reduce the eligible patient’s out-of-pocket costs to as low as $0 for each 30-day supply (1 inhaler), subject to a maximum savings limit; patient out-of-pocket expenses may vary. Reimbursement will be received from Change Healthcare.

Pharmacist Instructions for Insured/Not Covered Patients: Submit the claim to the primary Third-Party Payer first; if the primary claim submission shows a managed care restriction (step-edit, prior authorization, or NDC block), continue the claim adjudication process and submit the balance due to Change Healthcare as a Secondary Payer COB with patient responsibility amount and a valid Other Coverage Code of 3. This will reduce eligible patient’s out-of-pocket costs to as low as $40 for each 30-day supply (1 inhaler), subject to a maximum savings limit of $594.68 per 30-day supply (1 inhaler); patient out-of-pocket expenses may vary. Reimbursement will be received from Change Healthcare.

Pharmacist Instructions for a Cash-Paying Patient: Submit this claim to Change Healthcare. A valid Other Coverage Code (eg, 1) is required. The card will cover up to a maximum of $100 for each 30-day supply (1 inhaler). Reimbursement will be received from Change Healthcare. Valid Other Coverage Code Required. For any questions regarding Change Healthcare online processing, please call the Help Desk at 1-800-433-4893.

Frequently Asked Questions

What is the approved use for BREZTRI?

BREZTRI is a prescription medicine used long term to treat chronic obstructive pulmonary disease (COPD). COPD is a chronic lung disease...

What are COPD flare-ups?

A COPD flare-up—also known as an exacerbation—is a sudden worsening of your COPD symptoms that result in additional treatment. If your...

Are there savings offers for BREZTRI?

Yes. You may be eligible to pay as little as $0 on your prescription for BREZTRI for up to one year with BREZTRI Zero Pay. To find out if you qualify for...

How do I store my BREZTRI inhaler?

Store BREZTRI at room temperature between 68°F and 77°F (20°C and 25°C). Keep in a dry place away from heat and sunlight. Store BREZTRI in...

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APPROVED USE

BREZTRI AEROSPHERE is a medicine used long term to treat chronic obstructive pulmonary disease (COPD), including chronic bronchitis, emphysema, or both, for better breathing and fewer flare-ups.

BREZTRI is not used to relieve sudden breathing problems and will not replace a rescue inhaler. BREZTRI is not for the treatment of asthma.