For U. Healthcare Professionals For U. Healthcare Professionals English. Eligibility Requirements In order to be eligible for the program, you must meet the following requirements: You must be a resident of the U. Contact Us. Auto-refills terminate at the end of the patient's program enrollment period. Auto-refills are managed by the prescriber. If approved, you will receive a free day supply of insulin.
Novo Nordisk will check back with you before your day enrollment ends to determine continued eligibility. Assistance can be extended for otherwise eligible patients who have been denied Medicaid coverage. See the frequently asked questions below or call Novo Nordisk toll-free at Take the application and proof of income to your health care provider.
After the application is reviewed, you and your health care provider will be informed of the decision. Uninsured patients are enrolled for 12 months. Medicare patients are enrolled for a calendar year. 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. Once approved, a patient's medication should arrive at their prescriber's office within business days.
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 60 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.
Contact program Patient Assistance Program. Sanofi-Aventis Patient Assistance Program. Sanofi Patient Connection. Address: PO Box Charlotte, NC 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 diabetes medicine from Novo Nordisk. The Novo Nordisk Patient Assistance Program is based on our commitment to people living with diabetes and provides medication at no cost to those who qualify.
This is a good program. Once you qualify, you may be able to receive your medication for up to one year. Sanoficares Program tip www. Notice: Effective August 15th, , Lantus will no longer be offered on the Sanoficares program.
All other products will continue to be offered. Valid in Canada only. Patient Assistance Information - RxHope new www. A new application is required once a year. Click drug logo or drug name to start online application. Lantus Vials : Printable Application Forms. This is likely to be a more cost-effective option than other forms of cheap Lantus.
Lantus Solostar Patient assistance program - NiceRx top www. Start by filling in our enrollment application and tell us about any medications you're taking, including Lantus Solostar. We'll ask for details about your healthcare provider, insurance, and your household income as this is needed by the pharmaceutical companies who ship your medication. The Lantus Patient Assistance Program is aimed at mitigating the cost to individuals.
The dosage is based on your medical condition and response to therapy. Measure each dose very carefully; even small changes in the amount of insulin may have a large effect on your blood sugar levels. If you experience any of the symptoms of low blood sugar listed below in SIDE EFFECTS section , take a quick source of sugar such as glucose tablets, table sugar, orange juice, honey, or non-diet soda.
Promptly contact your doctor. Insulin glargine is not recommended to be given into a vein IV. Severe low blood sugar may result.
Do not mix this type of insulin with other insulin products or with other intravenous IV solutions. Before using, inspect this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard needles and medical supplies safely. Consult your pharmacist. Injection site reactions e. If any of these effects persist or worsen, notify your doctor.
Tell your doctor immediately if any of these serious side effects of high blood sugar hyperglycemia occurs: unusual drowsiness, confusion, rapid breathing, fruity breath odor, increased urination, unusual thirst.
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