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AstraZeneca Access 360TM is a program designed to connect patients to appropriate affordability programs and streamline access and reimbursement for AstraZeneca medicines.

Please select a medicine for additional information.

In order for Access 360 to provide you with patient-specific support, you or your legally authorized representative must complete Access 360's Patient Authorization Form that allows our team to assist you with access to care. Only one authorization is required per patient and it is valid for two years from the date of signature, unless a shorter period is required by state law. If you have any questions about this authorization please call us at 1-844-275-2360. Here are the ways you can facilitate patient authorization:

  • Have your patient call Access 360 at 1-844-275-2360 to provide authorization over the phone or you can call to request a form be mailed to your patient with a self-addressed stamped envelope
  • Have your patient complete online at www.MyAccess360PAF.com
  • Download and print a PDF from this website, then have your patient complete it and mail or fax to Access 360 Patient Authorization Form (PAF)

Please see the full Prescribing Information, including Boxed WARNING for LUMOXITI and Medication Guide

Forms & Downloads

Select an AstraZeneca Medicine

  • CALQUENCE® (acalabrutinib)
  • FASENRA (benralizumab)
  • FASLODEX® (fulvestrant)
  • FLUMIST® QUADRIVALENT (Influenza vaccine live, Intranasal)
  • IMFINZI® (durvalumab)
  • IRESSA® (gefitinib)
  • LYNPARZA® (olaparib)
  • LUMOXITI® (moxetumomab pasudotox-tdfk)
  • SYNAGIS® (palivizumab)
  • TAGRISSO® (osimertinib)