AstraZeneca Pty Ltd (“AstraZeneca”) and DKSH HEALTHCARE AUSTRALIA comply with the Australian Privacy Act 1988 (Cth) (“Privacy Act”) and the New Zealand Privacy Principles contained in the Privacy Act 2020 (NZ) to ensure that your personal information is protected. In this statement, all references to personal information include sensitive information (such as information about your health). If you are a patient, AstraZeneca and DKSH HEALTHCARE AUSTRALIA will collect and use your personal information to enrol you in, administer and continue to improve the Connect360 patient support program, including providing you with materials and services you request and contacting you for follow-up purposes related to the Connect360 program. AstraZeneca and DKSH HEALTHCARE AUSTRALIA will collect personal information directly from you where it is reasonable and practicable to do so. AstraZeneca and DKSH HEALTHCARE AUSTRALIA may also collect your personal information from your healthcare professional through the enrolment process. If you are a healthcare professional, AstraZeneca and DKSH HEALTHCARE AUSTRALIA will collect, hold, and use your personal information to deliver the Connect360 program to your enrolled patients and to continue to improve the Connect360 program, including contacting you for follow-up purposes and providing you with materials related to the Connect360 program. If you provide your email address, telephone and/or mobile phone number on this form, you also consent to AstraZeneca and DKSH HEALTHCARE AUSTRALIA using your email address, telephone and/or mobile phone number to contact you (including by SMS or email) for any of these purposes. Your consent will remain current until you advise us otherwise by writing to us at the relevant address below.
AstraZeneca may contract with other persons or organisations (such as DKSH HEALTHCARE AUSTRALIA) to assist in the provision of services under the Connect360 program, or for them to provide feedback to AstraZeneca on how the Connect360 program can be improved. Your personal information may be disclosed to such persons or organisations and, in providing a service, they may contact you directly. AstraZeneca requires these persons or organisations to maintain the confidentiality of your personal information and to only use that information for the services they perform. In some instances, they may disclose the personal information they collect from you to other third parties (such as mail houses) for the purposes of performing services relevant to the Connect360 program. If DKSH HEALTHCARE AUSTRALIA ceases to be involved in the Connect360 program, DKSH HEALTHCARE AUSTRALIA may transfer your personal information to AstraZeneca, or a third party nominated by AstraZeneca for the purposes of continuing the Connect360 program. AstraZeneca will handle all personal information it collects from third parties about you for the purposes and in the manner described in this privacy statement.
If you are a patient and you provide AstraZeneca and DKSH HEALTHCARE AUSTRALIA with the details of your healthcare professional, AstraZeneca and DKSH HEALTHCARE AUSTRALIA may disclose your personal information to that healthcare professional to confirm that you have enrolled in the Connect360 program. AstraZeneca may also use information that it collects as part of the Connect360 program in a de-identified form to inform doctors of patient experiences with Fasenra® (benralizumab), including via publication in medical journals and presentations at clinical meetings.
AstraZeneca continually monitors the safety profile of their products. To support this ongoing process, and to adhere with local and global regulatory obligations, details of any potential reports of Adverse Events (AE), special situations, and product quality complaints, in relation to a patient potentially administered an AstraZeneca product, identified as part of your participation in this activity, will be shared with AstraZeneca’s medical (pharmacovigilance) department. The information may be disclosed to local and overseas regulatory authorities or other third parties (such as those providing AE case processing activities, or license partners), for the purposes of meeting pharmacovigilance requirements. AstraZeneca’s medical (pharmacovigilance) team may wish to contact you, or your nominated Healthcare Professional (HCP), for further information regarding any adverse events, special situations, and product quality complaints, identified during your participation in this activity. Your agreement to this is voluntary, and you will be given the option to indicate your consent to this during the provision of the program services
AstraZeneca and DKSH HEALTHCARE AUSTRALIA may transfer your personal information overseas. In the event that AstraZeneca or DKSH HEALTHCARE AUSTRALIA transfer your personal information outside New Zealand, AstraZeneca and DKSH HEALTHCARE AUSTRALIA will comply with the requirements of the Privacy Act that relate to transborder data flows.
The Privacy Policies of AstraZeneca (available at: https://www.azprivacy.astrazeneca.com/asia-pacific/newzealand/en/privacy-notices.html ) and DKSH HEALTHCARE AUSTRALIA (email: www.dksh.com/au-en/home/privacy) contain further information about how you may access and/or correct the personal information held about you as required by law, as well as information about making a complaint about a breach of the Privacy Act and how AstraZeneca and DKSH HEALTHCARE AUSTRALIA will deal with such a complaint. AstraZeneca’s address is PO Box 87453, Meadowbank, Auckland 1742 and DKSH HEALTHCARE AUSTRALIA address is Level 2, 104 Mount Street, North Sydney NSW 2060.
Unless you inform us otherwise, by submitting this form, you consent to AstraZeneca and DKSH HEALTHCARE AUSTRALIA collecting, using, and disclosing your personal information in this way. If you do not provide the information to us, we will be unable to enrol you in the Connect360, although you will still be able to call AstraZeneca directly on 09 306 5650 or 0800 684 432 if you have any queries directly related to Fasenra®. You are able to withdraw from the Connect360 program at any time by advising us in writing at support@connect360asthma.co.nz.