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Individual costs and benefit design may vary. Please consult with individual plans for specific information.
AstraZeneca does not endorse any commercial, Medicare Part D, or Medicaid plan or plans.
Source: Fingertip Formulary® Database. Apr 29, 2018.
Tier 1 = lowest co-pay; Tier 2 = middle-level co-pay (preferred); Tier 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
SYMBICORT is covered for 9 out of 10 Commercial and Medicare Part D patients* nationwide1
*"Without Restrictions" means Tiers 1‐7 and the $0 Co‐pay Tier without prior authorizations or step therapy. Quantity limits may apply.
*“Patients” means covered lives (Commercial, Employer, FEHBP, Fed Prog, HIX, Municipal Plan, PBM, Pvt HIX, Union, EGWP, Medicare PDP, Medi-Medi, Medicare MA, Medicare SN, PACE) at Tiers 1–7 in the nation, as calculated by Fingertip Formulary® as of 3/7/2019.
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