Breztri Aerosphere (budesonide/glycopyrrolate/formoterol)
Patient Assistance Program Guide — AZ&Me Prescription Savings Program
Do You Qualify?
Income
Up to $45,180 for a single person
Insurance
Uninsured or have Medicare Part D and meet specific eligibility requirements; generally ineligible if enrolled in Medicaid or other government-funded insurance.
Residency
U.S. resident with a valid address
Income Limits (300% FPL)
Calculated based on 300% of the 2025 Federal Poverty Level.
Based on 2025 HHS Federal Poverty Level guidelines.
# AZ&Me Prescription Savings Program: A Patient Guide for Breztri Aerosphere
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Who Qualifies for the AZ&Me Prescription Savings Program?
If you take Breztri Aerosphere for COPD and struggle to afford it, you may be able to get it at little or no cost through the AZ&Me Prescription Savings Program, run by AstraZeneca, the maker of Breztri. To qualify, your household income generally must be at or below $45,180 per year for a single person (based on 300% of the 2025 Federal Poverty Level). Income limits are higher for larger households. On the insurance side, you typically must be either uninsured or enrolled in Medicare Part D — patients with Medicaid or other government-funded insurance are generally not eligible. If you meet both the income and insurance requirements, this program may cover your Breztri Aerosphere at no cost, with the medication shipped directly to your home.
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About Breztri Aerosphere (budesonide/glycopyrrolate/formoterol)
Breztri Aerosphere is a prescription inhaler used as a maintenance treatment for Chronic Obstructive Pulmonary Disease (COPD) in adults. It contains three active ingredients: budesonide (an inhaled corticosteroid, or ICS), glycopyrrolate (a long-acting muscarinic antagonist, or LAMA), and formoterol fumarate (a long-acting beta-agonist, or LABA). This combination makes it what is known as "triple therapy" — a single inhaler that delivers three types of medication at once. Breztri is approved by the U.S. Food and Drug Administration (FDA) for this use. Without insurance or assistance, the monthly cost of Breztri Aerosphere can run several hundred dollars, placing it out of reach for many patients on fixed or limited incomes.
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Income Eligibility: Full Breakdown
The AZ&Me Prescription Savings Program uses income thresholds set at 300% of the 2025 Federal Poverty Level. Here is how the limits break down by household size:
| Household Size | Max Annual Income |
|---|---|
| 1 person | $45,180 |
| 2 persons | $61,320 |
| 3 persons | $77,460 |
| 4 persons | $93,600 |
Your household size includes everyone living with you who shares finances — not just the people listed on your insurance or tax return. Income is typically verified using your most recent federal tax return, a W-2 form, or three months of recent pay stubs. If your income fluctuates (such as from seasonal work or self-employment), the program may consider other documentation.
If your income falls above these limits, you will not automatically qualify for free medication through AZ&Me, but you may still have options. AstraZeneca's savings card program for commercially insured patients is a separate option worth exploring. It is always worth applying even if you are unsure — the program makes the final eligibility determination, not you or your doctor.
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Insurance Requirements Explained
Understanding your insurance situation is key before applying. Here is how different coverage types affect your eligibility:
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Step-by-Step: How to Apply
Follow these steps to apply for free Breztri Aerosphere through the AZ&Me Prescription Savings Program:
1. Review eligibility first. Visit https://www.breztri.com/financial-support to confirm current program requirements before gathering documents.
2. Gather your documents. You will need:
- A completed application form (available online or by phone), with your physician's signature
- Proof of income: your most recent federal tax return, a W-2, or three months of pay stubs
- A valid prescription for Breztri Aerosphere from your doctor
3. Choose how to apply. You have three options:
- Online: Go to https://www.azandmeapp.com/ to complete and submit your application electronically
- By phone: Call (800) 292-6363 to apply with the help of a program representative
- By fax: Fax your completed paperwork to (800) 961-8323
4. Submit all required documents together. Incomplete applications are the most common reason for delays. Make sure your physician has signed the form before you submit.
5. Wait for confirmation. After submission, processing typically takes 7 to 10 business days. You will receive notification about your approval status.
6. Receive your medication. If approved, Breztri Aerosphere will be shipped directly to your home at no charge.
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What to Expect: Timeline and Delivery
Once you submit a complete application, processing typically takes 7 to 10 business days. AstraZeneca or a program representative will contact you — and likely your prescribing doctor — to confirm approval. If approved, your Breztri Aerosphere will be mailed directly to your home address. You do not need to pick it up at a pharmacy or bring anything to a doctor's office. Enrollment in the AZ&Me program is not permanent — you will need to reauthorize your enrollment once per year to continue receiving medication at no cost. Watch for renewal notices and be ready to submit updated income documents when that time comes.
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Alternatives If You Don't Qualify
If the AZ&Me program is not the right fit for you, here are other options to consider:
1. Biosimilar alternatives: There are currently no FDA-approved biosimilar or generic versions of Breztri Aerosphere available in the United States. This option is not available at this time.
2. Manufacturer savings card (for insured patients): If you have commercial or private insurance, AstraZeneca offers a separate Breztri savings card that may reduce your out-of-pocket costs significantly. Visit https://www.breztri.com/cost-and-savings.html to learn more.
3. State Pharmaceutical Assistance Programs (SPAPs): Many states run their own drug assistance programs, often for seniors or people with disabilities. These programs sometimes work alongside Medicare Part D. Search your state's health department website to see what may be available to you.
4. NeedyMeds.org: This free, independent database at https://www.needymeds.org lets you search for assistance programs by drug name or diagnosis. It is a helpful resource if you are exploring all available options.
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*This guide is for informational purposes only and does not constitute medical or legal advice. Eligibility determinations are made solely by AstraZeneca. Program terms may change — verify current requirements at [https://www.breztri.com/financial-support](https://www.breztri.com/financial-support) before applying.*
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Documents You'll Need
If You Don't Qualify for the Assistance Program
Manufacturer Savings Card (for insured patients)
AstraZeneca offers a savings card that may reduce your out-of-pocket cost if you have commercial insurance. Ask your prescriber or pharmacist for current savings card details.
Common Questions
Yes. Unlike many manufacturer programs, AZ&Me does have provisions for patients enrolled in Medicare Part D. You must still meet the income eligibility requirements. Contact AstraZeneca at (800) 292-6363 to confirm your specific situation before applying.
Processing typically takes 7 to 10 business days after AstraZeneca receives your complete application. Once approved, your Breztri Aerosphere is shipped directly to your home. Make sure your application includes all required documents — including your doctor's signature — to avoid delays.
Yes. Enrollment in the AZ&Me Prescription Savings Program requires annual reauthorization. You will need to submit updated income documentation and a renewed application each year to continue receiving Breztri at no cost. Watch for renewal notices from AstraZeneca as your enrollment period approaches.
If your income exceeds the program's threshold, you may not qualify for the AZ&Me free medication program. However, you may be eligible for AstraZeneca's savings card if you have commercial insurance. You can also explore NeedyMeds.org or your state's pharmaceutical assistance program for additional options.
No. As of now, there are no FDA-approved generic or biosimilar versions of Breztri Aerosphere on the market. The AZ&Me program and the manufacturer savings card are currently the main ways to reduce the cost of this specific medication.
Ready to Apply for Breztri Aerosphere Assistance?
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