The Novo Nordisk Patient Assistance Program (PAP) is based on our commitment to our patients. The Patient Assistance Program provides medication at no cost to those who qualify.
Patients who are approved for the PAP may qualify to receive free medicine from Novo Nordisk. There is no registration charge or monthly fee for participating.
Click here for a list of our Novo Nordisk products covered by the PAP.
The Novo Nordisk Patient Assistance Program (PAP) is based on our commitment to our patients. The Patient Assistance Program provides medication at no cost to those who qualify.
Patients who are approved for the PAP may qualify to receive free medicine from Novo Nordisk. There is no registration charge or monthly fee for participating.
Click here for a list of our Novo Nordisk products covered by the PAP.
Please select one product here. If you will be applying for multiple products, you will be able to do so during the application process.
The Urgent Need Program is meant for patients who have less than 7 days of insulin remaining. The Continuing Need Program is for all other applicants.
To be eligible for this program, you must:
See the frequently asked questions below or call Novo Nordisk toll-free at 1‑866‑310‑7549.
Note: Applying online is only available in English
Before you start your application
You'll most likely need:
Note: Please verify your health care provider’s email address before beginning. Your health care provider will receive a copy of your application by email and must fill out certain portions to complete it.
Other items you may need:
STEP 1: Download and fill out the application
Complete the following sections:
STEP 2: Gather proof of income
Make a copy of one of the following items to show your adjusted gross annual household income:
STEP 3: Ask your health care provider to complete the application
Take your application and proof of income to your health care provider and have them:
Please allow up to 10 business days for the processing.
Note: After the application is reviewed, you and your health care provider will be informed of the decision. If approved, your medicine will be sent to your health care provider’s office, where you can pick it up.
Product availability subject to change without notice.
Novo Nordisk reserves the right to modify or cancel this program at any time without notice.
Do not include patient medical records with this application
Patients must be a US citizen or legal resident, must have a total household income at or below 400% of the federal poverty level, and must be uninsured or have Medicare.
Uninsured patients are enrolled for 12 months. Medicare patients are enrolled for a calendar year.
No, we no longer require that Medicare Part D patients spend $1000 out of pocket to be eligible for the program.
Applying online can be fast and easy. You'll go through a step-by-step process that tells you what to do next, with simple questions and answers. However, if you don't have internet access or are simply more comfortable applying by paper, this is also a great option.
Please note: If you speak Spanish, please use the paper/PDF format.
If an application is submitted with all supporting documentation and all required fields completed, it will be processed within 2 business days. Any missing or incomplete information may cause a delay.
If approved, patients will receive a letter in the mail. Also, if a patient opts in for automated phone notification on the application, they will receive an automated recorded phone message notification.
Health care providers will receive a letter via fax.
Once approved, a patient's medication should arrive at their prescriber's office within 10-14 business days.
Unfortunately, we are currently not able to ship directly to patients.
Unfortunately, we are currently not able to ship directly to a pharmacy.
Please contact us at 1-866-310-7549 so we can provide additional direction.
Please contact us at 1-866-310-7549 so we can update your records.
Please contact us at 1-866-310-7549 so we can update your records.
Yes. Patients will need to submit a new application and supporting documentation when their enrollment ends if they'd like to be considered for continued support. Patients should be sure to submit the latest version of the application, which is available on this page in the "Patient Assistance Program forms" section above.
Patients may submit a new application 30 days prior to the end of their enrollment. Medicare Part D patients may apply after October 15th of the current year to enroll for the following year.
Individuals with Medicare Part D coverage may apply for 2023 PAP enrollment after October 15th, 2022. Please complete the latest version of the application available online or for download above. Be sure to enter the correct enrollment year when completing the Medicare Part D Enrollment Consent.
For added convenience and at the direction of the prescriber, the Novo Nordisk PAP now offers automatic refills for most medications.
All new applicants will be automatically enrolled. The medication will ship to the prescriber of an approved enrollee/applicant in accordance with current program guidelines with minimal involvement on behalf of the prescriber. Auto refills terminate at the end of the patient's program enrollment period. Auto refills are managed by the prescriber.
To be eligible for this program, you must:
Call Novo Nordisk toll-free at 1-866-310-7549.
Call Novo Nordisk toll-free at 1-866-310-7549.
STEP 1
STEP 2
STEP 3
Patients and prescribers will be notified of the decision by mail. If approved, a 120-day supply of insulin will be shipped to the residence listed on your application. Someone will reach out to you directly to schedule a time for the delivery.
Patients and prescribers will be notified of the decision by mail. If approved, a 120-day supply of insulin will be shipped to the residence listed on your application. Someone will reach out to you directly to schedule a time for the delivery.
NOTE: If you are applying for both insulin and non-insulin, you can complete the general PAP application (click here) and advise your health care provider to include both medications in the Rx section.
To be eligible for this program, you must:
Call Novo Nordisk toll-free at 1-866-310-7549.
Call Novo Nordisk toll-free at 1-866-310-7549.
STEP 1
STEP 2
If you are a pharmacist in the state of Maine, contact 1-833-538-0027
To be eligible for this program, you must:
Call Novo Nordisk toll-free at 1-866-310-7549.
Call Novo Nordisk toll-free at 1-866-310-7549.
STEP 1
STEP 2
STEP 3
Patients and prescribers will be notified of the decision by mail. If approved, a 120-day supply of insulin will be shipped to the residence listed on your application. Someone will reach out to you directly to schedule a time for the delivery.
Patients and prescribers will be notified of the decision by mail. If approved, a 120-day supply of insulin will be shipped to the residence listed on your application. Someone will reach out to you directly to schedule a time for the delivery.
NOTE: If you are applying for both insulin and non-insulin, you can complete the general PAP application (click here) and advise your health care provider to include both medications in the Rx section.
To be eligible for this program, you must:
Call Novo Nordisk toll-free at 1-866-310-7549.
Call Novo Nordisk toll-free at 1-866-310-7549.
STEP 1
STEP 2
To be eligible for this program, you must:
Call Novo Nordisk toll-free at 1-866-310-7549.
Call Novo Nordisk toll-free at 1-866-310-7549.
If you are a pharmacist in the state of Colorado, contact 1-833-538-0027
If you are a pharmacist in the state of Colorado, contact 1-833-538-0027
To be eligible for this program, you must:
Call Novo Nordisk toll-free at 1-866-310-7549.
Call Novo Nordisk toll-free at 1-866-310-7549.
If you are a pharmacist in the state of Colorado, contact 1-833-538-0027
If you are a pharmacist in the state of Colorado, contact 1-833-538-0027
It’s important to properly dispose of your used Novo Nordisk products.
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