Victoza® Instant Savings Card and eVoucherRx™ Program
By participating in this savings program, participants understand and agree that the information provided, as well as the information obtained about them from the pharmacy, will be shared with the manufacturer and any companies working with the manufacturer. Participants also affirm that they will not submit, and have not had submitted on their behalf, a claim for reimbursement or coverage for items purchased with this card under Medicaid, Medicare, TRICARE, or any other federal or state government healthcare program, or where prohibited by state law.
Terms and conditions:
Offer applies to out-of-pocket expenses greater than $25. Out-of-pocket expenses greater than $25 will be covered up to $150 per prescription. This savings is valid for a maximum of 24 prescription copay benefits per patient. If your copay is already $25 or less, this offer does not apply.
Offer not valid for prescriptions paid in part or full by any federally or state-funded programs, including but not limited to Medicare or Medicaid, Medigap, VA, DOD, TRICARE, and where prohibited by law.
This savings program cannot be combined with any other coupon, certificate, voucher, or similar offer.
Offer good only in the USA and Puerto Rico at participating retail pharmacies and cannot be redeemed at government-subsidized clinics. Void where taxed, restricted, or prohibited by law.
Offer not extended to clubs, groups, or organizations.
Participation in this program must comply with all applicable laws and contractual or other obligations as a pharmacy provider.
This is not an insurance program.
Participating patients and pharmacists understand and agree to comply with the terms and conditions of this offer as set forth herein.
Participating patients must re-present their Instant Savings Card if changing pharmacies.
Any step-edits or prior authorizations required by the insurance plan still apply.
This offer is void where taxed, restricted, or prohibited by law.
The Victoza® Instant Savings Card may be used for mail order. This card is not transferable.
This offer is limited to 1 card per patient.
Novo Nordisk reserves the right to modify or cancel this program at any time.
The Victoza® Instant Savings Card is not extened on prescriptions for cash-paying customers.
Contact us at 1-877-4-VICTOZA(1-877-484-2869) or enter your phone number and click the “Call me” button. (You will need an open phone line.) We’ll connect you directly with a VictozaCare™ Specialist to answer your questions about Victoza®.