^†The healthcare provider remains responsible for populating all clinical content.

^‡Eligibility criteria and terms and conditions apply. Patients are not eligible for the program if they are self-paying or if the patient is enrolled in a state or federal healthcare program. There is a maximum benefit limit of $20,000 for product cost share per calendar year and $1,500 for the administration cost share reimbursement to the patient. If the patient’s total out-of-pocket bill exceeds the cap established by Astellas, the patient will be responsible for the additional balance. Patients residing in Massachusetts and patients receiving IZERVAY treatment in Massachusetts may be eligible for copay assistance for the cost of IZERVAY only, and are not eligible for copay assistance for the administration of IZERVAY. Offer is not health insurance and is void where prohibited by law. Astellas reserves the right to revoke, rescind, or amend this offer without notice for any reason. For full terms and conditions, visit IZERVAYecp.com/PatientSupport.

^§Eligibility criteria and terms and conditions apply. For full terms and conditions, visit IZERVAYecp.com/PatientSupport.

^||The responsibility to determine coverage, reimbursement, and appropriate coding for a patient remains at all times with the provider. Information provided by IZERVAY My Way should in no way be considered a guarantee of coverage or reimbursement for any product or service.