Novo Nordisk Hormone Therapy Patient Assistance Program

Summary

Novo Nordisk Pharmaceuticals, Inc. is located in Princeton, New Jersey and is the United States affiliate with Novo Nordisk A/S in Copenhagen, Denmark, which is the world leader in treatment for diabetes. Novo Nordisk creates, supplies, inspects, packages, and distributes enough insulin based products to satisfy the United States. Novo also exports to countries such as the remaining North American countries, Europe, China, New Zealand, and Australia. Having just acquired a new research and development and manufacturing center in Silicon Valley, California, Novo plans to eradicate diabetes by finding the best solution to the problem.

Activella is an ovarian hormone therapy launched by Novo Nordisk Pharmaceuticals, Inc. in 1998. Activella has been approved by the FDA to help the body continue to produce estrogen and progestins when it is deficient. Activella is administered orally via a tablet.

Vagifem is a product that treats vaginal menopause, and was launched by Novo Nordisk Pharmaceuticals, Inc. in March of 1999. Vagifem has been approved by the FDA to treat vaginal menopause symptoms. Vagifem is administered vaginally via a tablet.

Eligibility

Novo Nordisk Hormone Therapy Patient Assistance Program, a patient assistance program provided by Novo Nordisk Pharmaceuticals, Inc., offers a five month supply of Activella and Vagifem at no cost to those who are eligible for the program. Eligibility is based off of the following requirements:

- You must not be covered by private or public health insurance.

- Your income must be less than or equal to 200% of the Federal Poverty Guideline for the size of your household (see chart below).

- You must be a citizen of the United States or its Territories

- Should you be eligible, or enrolled in Medicare Part D but in the donut hole, you will become ineligible for this program.

The medication must be sent to the physicians office.

Those eligible for Medicare Part D but not enrolled may still be eligible.

SOURCE: 2008 Poverty Chart

Family Size

300%

250%

200%

150%

133%

100%

$32,490

$27,075

$21,660

$16,245

$14,404

$10,830

$43,710

$36,425

$29,140

$21,855

$19,378

$14,570

$54,930

$45,775

$36,620

$27,465

$24,352

$18,310

$66,150

$55,125

$44,100

$33,075

$29,327

$22,050

$77,370

$64,475

$51,580

$38,685

$34,301

$25,790

$88,590

$73,825

$59,060

$44,295

$39,275

$29,530

$99,810

$83,175

$66,540

$49,905

$44,249

$33,270

$111,030

$92,525

$74,020

$55,515

$49,223

$37,010

Each Additional Family Member

$11,220

$9,350

$7,480

$5,610

$4,974

$3,740

What´s Next?

Fill out the program enrollment form located to your right. If you don't see an enrollment form available please call Novo Nordisk Pharmaceuticals, Inc. program directly. After filling out the enrollment form please bring the form to your doctor for proper signatures and procedures. Do not forget a self stamped envelope for them to mail in your application to the program.

Other Tips

If you have any questions please call the Novo Nordisk Pharmaceuticals, Inc. program directly.
Fill out as much of the information on the enrollment form as possible. The more information you have pre-filled the easier the progrm is to enroll in.
Write down the refill dates for your program and set a reminder here on PatientAssistance.com so that you don't run out of medication.
Do not write messy on your forms as this will delay any response.
Call and write thank you notes to AAI Pharma Inc. program. Without their help millions of people will be without medication.