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Norditropin® (somatropin) injection 5 mg, 10 mg, 15 mg, and 30 mg terms and conditions

Eligibility and Restrictions:

In order to redeem this offer, patient must have a valid prescription for the brand being filled. A valid Prescriber ID# is required on the prescription. Patient is not eligible if he/she is enrolled in any federal or state health care program with prescription drug coverage, such as Medicaid, Medicare, Medigap, VA, DOD, TRICARE, or any similar federal or state health care program (each a Government Program), or where prohibited by law. Patient must be enrolled in a commercial insurance plan. The brand and the prescription being filled must be covered by the patient’s commercial insurance plan. Offer excludes full cash-paying patients. This offer may not be redeemed for cash. This offer is not valid when the entire cost of your prescription drug is eligible to be reimbursed by a commercial insurance plan or other commercial health or pharmacy benefit programs. By using this offer, you are certifying that you meet the eligibility criteria and will comply with the terms and conditions described herein and will not seek reimbursement for any benefit received through this offer. Novo Nordisk’s Eligibility and Restrictions, and Offer Details may change from time to time, and for the most recent version, please visit https://www.novocare.com/eligibility/norditropin-savings-card.html. Re-confirmation of information may be requested periodically to ensure accuracy of data and compliance with terms. Patients with questions about the Savings Offer may call 1-866-316-2404.

This offer is valid in the United States, and its territories, unless prohibited by law and may be redeemed at participating retail pharmacies. Availability of the Savings Offer in Massachusetts will be dependent upon state law in effect at the time patient presents the Savings Offer when paying for the covered medications.

This offer is not transferable and is limited to one offer per person. Not valid if reproduced.

Cash Discount Cards and other non-insurance plans are not valid as primary insurance under this offer. If the patient is eligible for drug benefits under any such program, the patient cannot use this offer. This Savings Offer cannot be combined with any coupon, certificate, voucher, or similar offer.

Patient is responsible for complying with any insurance carrier copayment disclosure requirements, including disclosing any savings received from this program. Novo Nordisk intends that all savings from this offer accrues to the patient. It is illegal to (or offer to) sell, purchase, or trade this offer.

This program is managed by ConnectiveRx on behalf of Novo Nordisk. The parties reserve the right to rescind, revoke, or amend this offer without notice at any time.

 

Offer Details:

As of January 1, 2023 (“Effective Date”) commercially insured patients with Norditropin® coverage, including those within their deductible phase, may pay as little as (“PALA”) $0 with an annual maximum cap of $1,500. Annual maximum cap of $1,500 will reset every January 1st until program expiration.

Pharmacist:

When you apply this offer, you are certifying that you have not submitted a claim for reimbursement under any Government Program for this prescription, or where prohibited by law. Participation in this program must comply with all applicable laws and regulations as a pharmacy provider. By participating in this program, you are certifying that you will comply with the eligibility criteria, and terms and conditions described herein. You also certify that you will not seek reimbursement for any benefit received through this offer.

Pharmacist instructions for a patient with an Eligible Third Party:

Submit the claim to the primary Third Party Payer first, then submit the balance due to CHANGE HEALTHCARE as a Secondary Payer COB [coordination of benefits] with patient responsibility amount and a valid Other Coverage Code, (eg, 8). The patient is responsible initially for the PALA amount and the offer pays up to the Savings Benefit. Offer excludes full cash-paying patients. Reimbursement will be received from CHANGE HEALTHCARE. For any questions regarding CHANGE HEALTHCARE online processing, please call the Help Desk at 1–800–433–4893.

Standard (v9) Novocare

Norditropin® Selected Important Safety Information

Do not use Norditropin® if:

  • you have a critical illness caused by certain types of heart or stomach surgery, trauma or breathing (respiratory) problems
  • you are a child with Prader-Willi syndrome who is severely obese or has breathing problems including sleep apnea
  • you have cancer or other tumors
  • you are allergic to somatropin or any of the ingredients in Norditropin®
  • your healthcare provider tells you that you have certain types of eye problems caused by diabetes (diabetic retinopathy)
  • you are a child with closed bone growth plates (epiphyses)

What is Norditropin® (somatropin) injection?

Norditropin® is a prescription medicine that contains human growth hormone and is used to treat:

  • children who are not growing because of low or no growth hormone
  • children who are short (in stature) and who have Noonan syndrome, Turner syndrome, or were born small (small for gestational age-SGA) and have not caught-up in growth by age 2 to 4 years
  • children who have Idiopathic Short Stature (ISS)
  • children who are not growing who have Prader-Willi syndrome (PWS)
  • adults who do not make enough growth hormone

Norditropin® Important Safety Information

Do not use Norditropin® if:

  • you have a critical illness caused by certain types of heart or stomach surgery, trauma or breathing (respiratory) problems
  • you are a child with Prader-Willi syndrome who is severely obese or has breathing problems including sleep apnea
  • you have cancer or other tumors
  • you are allergic to somatropin or any of the ingredients in Norditropin®
  • your healthcare provider tells you that you have certain types of eye problems caused by diabetes (diabetic retinopathy)
  • you are a child with closed bone growth plates (epiphyses)

Before taking Norditropin®, tell your healthcare provider about all of your medical conditions, including if you:

  • have had heart or stomach surgery, trauma or serious breathing (respiratory problems)
  • have had a history of problems breathing while you sleep (sleep apnea)
  • have or have had cancer or any tumor
  • have diabetes
  • are pregnant or breastfeeding, or plan to become pregnant or breastfeed

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Norditropin® may affect how other medicines work, and other medicines may affect how Norditropin® works.

How should I use Norditropin®?

  • Use Norditropin® exactly as your health care provider tells you to
  • Do not share your Norditropin® pens and needles with another person even if the needle has been changed. You may give another person an infection or get an infection from them.

What are the possible side effects of Norditropin®?

Norditropin® may cause serious side effects, including:

  • high risk of death in people who have critical illnesses because of heart or stomach surgery, trauma or serious breathing (respiratory) problems
  • high risk of sudden death in children with Prader-Willi syndrome who are severely obese or have breathing problems including sleep apnea
  • increased risk of growth of cancer or a tumor that is already present and increased risk of the return of cancer or a tumor in people who were treated with radiation to the brain or head as children and who developed low growth hormone problems. Contact the healthcare provider if you or your child start to have headaches, or have changes in behavior, changes in vision, or changes in moles, birthmarks, or the color of your skin
  • new or worsening high blood sugar (hyperglycemia) or diabetes
  • increase in pressure in the skull (intracranial hypertension). If you or your child has headaches, eye problems, nausea or vomiting, contact the healthcare provider
  • serious allergic reactions. Get medical help right away if you or your child has the following symptoms: swelling of your face, lips, mouth or tongue, trouble breathing, wheezing, severe itching, skin rashes, redness or swelling, dizziness or fainting, fast heartbeat or pounding in your chest, or sweating
  • your body holding too much fluid (fluid retention) such as swelling in the hands and feet, pain in your joints or muscles or nerve problems that cause pain, burning, or tingling in the hands, arms, legs and feet. Tell your healthcare provider if you have any of these signs or symptoms of fluid retention.
  • decrease in a hormone called cortisol. Tell your or your child’s healthcare provider if you or your child has darkening of the skin, severe fatigue, dizziness, weakness or weight loss
  • decrease in thyroid hormone levels
  • hip and knee pain or a limp in children (slipped capital femoral epiphysis)
  • worsening of pre-existing curvature of the spine (scoliosis)
  • severe and constant abdominal pain can be a sign of pancreatitis. Tell your or your child’s healthcare provider if you or your child has any new abdominal pain.
  • loss of fat and tissue weakness in the area of skin you inject
  • increase in phosphorus, alkaline phosphatase, and parathyroid hormone levels in your blood

The most common side effects of Norditropin® include:

  • injection site reactions and rashes, and headaches

Please click here for Norditropin® Prescribing Information.

Norditropin® is a prescription medication.

Novo Nordisk provides patient assistance for those who qualify. Please call 1-866-310-7549 to learn more about Novo Nordisk assistance programs.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Talk to your health care provider and find out if Norditropin® is right for you or your child.