Victoza

Indicated For

Type 2 diabetes

About This Medication

# Novo Nordisk Patient Assistance Program Guide: How to Get Victoza at Low or No Cost ## About This Program The Novo Nordisk Patient Assistance Program (PAP) is designed to help uninsured and underinsured patients access Victoza (liraglutide) at little to no cost. Victoza is a GLP-1 receptor agonist medication used to treat type 2 diabetes and reduce the risk of cardiovascular disease. If you're struggling to afford this medication, this program may be able to help. ## What Is Victoza? Victoza is a prescription medication that helps control blood sugar levels in adults with type 2 diabetes. It also helps reduce the risk of heart attack and stroke in patients with type 2 diabetes and heart disease risk factors. The medication works by mimicking a natural hormone that helps your body produce insulin when needed. ## Who Can Qualify? You may be eligible for the Novo Nordisk PAP if you meet ALL of these criteria: - You are a U.S. resident - You have a valid prescription for Victoza from your doctor - You are **uninsured or underinsured** (meaning your insurance doesn't cover Victoza or your out-of-pocket costs are too high) - Your household income is at or below **400% of the Federal Poverty Level (FPL)** - Your doctor supports your participation in the program ## Income Eligibility Chart Use this chart to see if your household income may qualify. If your household income is at or below the amount listed for your family size, you likely qualify: | Household Size | Maximum Annual Income (400% FPL) | |---|---| | 1 person | $17,840 | | 2 people | $24,080 | | 3 people | $30,320 | | 4 people | $36,560 | | 5 people | $42,800 | | 6 people | $49,040 | | 7 people | $55,280 | | 8 people | $61,520 | | Each additional person | Add $6,240 | **Note:** These are 2024 estimates and may change yearly. Contact the program to confirm your eligibility. ## Insurance Requirements You must be either: - **Uninsured** (have no health insurance coverage), OR - **Underinsured** (have insurance that doesn't cover Victoza or has high out-of-pocket costs) If you have Medicare, Medicaid, or other government insurance, you may still qualify if Victoza isn't covered or is unaffordable for you. ## What You'll Need to Apply Before you start the application, gather these documents: 1. **Doctor's Documentation**: Your doctor must sign and date the application form confirming that Victoza is medically necessary for you. Your doctor's office can help with this. 2. **Income Verification**: Provide one of the following to prove your household income: - Recent tax returns (last 2 years) - Pay stubs (last 30 days) - Benefit statements (Social Security, unemployment, etc.) - Letter from employer stating your salary - Bank statements showing regular deposits 3. **Insurance Status Documentation**: Proof of your insurance situation: - If uninsured: Letter from your employer stating no health insurance is available, or explanation of why you have no insurance - If underinsured: Copy of your insurance card and explanation of coverage gaps, or evidence that your insurance denies Victoza coverage ## Step-by-Step Application Instructions ### Step 1: Get Your Doctor's Approval Call or visit your doctor's office and ask them to participate in the Novo Nordisk PAP. Explain that you need help affording Victoza. Your doctor will need to complete the medical part of the application confirming that Victoza is appropriate for you. ### Step 2: Choose Your Application Method You can apply in multiple ways: - **Online**: Visit https://www.novocare.com/diabetes/help-with-costs/pap.html to start your application - **By Phone**: Call **(866) 310-7549** to apply with a patient assistance specialist - **Mail**: Request an application form and mail it in with all required documents ### Step 3: Complete the Application You'll be asked to provide: - Your personal information (name, address, phone, date of birth) - Your household income and family size - Your insurance status - Your doctor's information and signature - Your medical necessity information ### Step 4: Submit Required Documents Include with your application: - Proof of income (tax return, pay stub, or benefit letter) - Insurance status documentation - Doctor's signed authorization - Any other documents the program requests ### Step 5: Wait for Approval The program typically makes a decision within **2-4 weeks**. They will contact you by phone or mail with their decision. ### Step 6: Receive Your Medication If approved, your Victoza will be **shipped directly to you** at no cost or very low cost. Your doctor will be notified, and you can continue receiving refills as long as you meet program requirements. ## Timeline and What to Expect - **Application review**: 2-4 weeks - **Decision notification**: By phone or mail - **Medication delivery**: Ships after approval - **Refills**: Contact the program or your doctor to request refills - **Reauthorization**: Required annually—you'll need to reapply each year ## What If I'm Denied? If your application is denied, you have options: 1. **Ask why**: Request an explanation from the program. Common reasons include income over the limit or insurance coverage availability. 2. **Appeal**: If your circumstances have changed, you may be able to reapply. 3. **Explore alternatives**: - Ask your doctor about generic liraglutide options - Speak with your insurance company about coverage or prior authorization - Contact Novo Nordisk directly at (866) 310-7549 to discuss other options - Search for additional assistance through NeedyMeds.org - Contact your state's pharmaceutical assistance program ## Annual Reauthorization Your assistance is **not automatic every year**. You must reauthorize annually by: 1. Contacting the program before your assistance expires 2. Updating your income and insurance information 3. Providing new income verification documents 4. Getting your doctor's updated confirmation The program will notify you when reauthorization is needed. ## Important Questions to Ask - How long will my assistance last? - How much will I pay for Victoza through this program? - What happens when my prescription runs out? - Can I switch between different dose strengths? - What if my income or insurance changes during the year? ## Contact Information **Novo Nordisk Patient Assistance Program** - **Phone**: (866) 310-7549 - **Website**: https://www.novocare.com/diabetes/help-with-costs/pap.html - **Hours**: Monday-Friday, 9 AM-5 PM EST ## Legal Disclaimer This guide is for informational purposes only and does not constitute medical advice. The information provided is based on current program requirements and may change at any time. For the most accurate and up-to-date information about eligibility requirements, income thresholds, and application procedures, please contact the Novo Nordisk Patient Assistance Program directly or visit their website. Always consult with your healthcare provider regarding your diabetes treatment and medication options. The Novo Nordisk PAP does not replace professional medical advice or treatment from your doctor. By applying for this program, you are authorizing Novo Nordisk and the program administrator to verify your income, insurance status, and other eligibility information as needed. --- **Last Updated**: 2024. Income limits and program details are subject to change. Always verify current requirements with the program directly.

Program information last verified: March 25, 2026