Rare Bleeding Disorders Free Product Programs Terms and Conditions

Trial, JumpStart™, and Interim Program eligibility

Patients who have been prescribed for an FDA-approved indication and who have commercial insurance may be eligible to receive a limited supply of free product from Trial, JumpStart™, or the Interim Program. Patients who participate in any government, state, or federally funded medical or prescription benefit programs, including Medicare, Medicaid, Medigap, VA, DOD, and TRICARE, including patients who participate in a managed Medicaid program or have Medicaid as secondary insurance, are not eligible to participate in Trial, JumpStart™, or the Interim Program.

Trial, JumpStart™, and Interim Program product is provided at no cost to the patient or the HCP and is not contingent on any product purchase. The patient and HCP must not: (1) bill any third party for the free product or (2) resell the free product.

Patient Assistance Program (PAP) eligibility

The Patient Assistance Program (PAP) supports eligible patients prescribed Novo Nordisk medications free of charge. The patient must be uninsured; be prescribed for on-label diagnosis; be a resident of the US, Puerto Rico, or a US territory; and meet income qualifications.