| What is Viberzi? |
A once‑weekly GLP‑1 receptor agonist (dulaglutide) used to improve glycemic control in adults with type 2 diabetes. |
| Who can use the copay card? |
• Adults with type 2 diabetes who are prescribed Viberzi
• Patients without prescription drug coverage, or whose insurance does not cover Viberzi fully.
• Not available to patients with Medicare Part D, Medicaid, or those on a pharmacy‑benefit manager (PBM) plan that already has a generic/brand‑name agreement with Viberzi. |
| What does the card cover? |
• Up to $200 per prescription (usually the 4‑week supply)
• Covers the copay for the first 12 months of therapy
• You keep the card for as long as you stay on Viberzi (no renewal needed). |
| How to apply |
1. Online:
• Visit Viberzi Copay Card page
• Click “Apply Now” and fill out the eligibility form.
2. By phone: Call 1‑855‑538‑4660 (toll‑free in the U.S.) and a rep will guide you through the application.
3. At the pharmacy: Many pharmacies can request the card for you during the refill.
4. By mail: Send a copy of your prescription and insurance information to
Viberzi Copay Card
Attn: Patient Assistance
c/o Novo Nordisk
P.O. Box 1060
Burlington, MA 01803-1060 |
| Key eligibility requirements |
• Must be on a Viberzi prescription (4‑week supply)
• Must be 18 + years old (or the parent/guardian of a minor)
• Must not have a current prescription drug benefit that fully covers Viberzi
• Must not be on a pharmacy‑benefit manager that already offers a Viberzi discount (e.g., some large PBMs) |
| What you’ll get |
• A free paper card that shows the copay amount you’ll pay.
• The card is valid for one prescription per 12‑month period, but you can keep it for the duration of your treatment. |
| Limitations & Exclusions |
• Not a savings program for patients with active prescription drug coverage.
• Not applicable if your insurance pays less than $200 per prescription (in that case you already have a better benefit).
• The card does not cover the initial $1,000 diagnostic testing or the cost of the first visit with your healthcare provider. |
| Typical copay amounts |
|
• With insurance: $50–$100 (depending on your plan) – the card covers the difference up to $200.
• Without insurance: The card will cover the full $200 copay, meaning you pay the manufacturer’s copay for the first 12 months. |
| FAQs |
Q: Will the card be accepted at every pharmacy?
A: Yes, most retail and chain pharmacies accept the card. If a pharmacy can’t process it, they’ll usually offer a temporary $0 copay and you can get the card directly from Novo Nordisk.
Q: Can I use the card if I have a flexible spending account (FSA) or health savings account (HSA)?
A: Yes – the card is a separate benefit and can be used in addition to FSA/HSA funds.
Q: What if my insurance changes during therapy?
A: If you switch to a plan that covers Viberzi fully, you can stop using the card; otherwise, the card remains valid for the remainder of your 12‑month period. |
| Contact information |
• Phone: 1‑855‑538‑4660 (toll‑free, US)
• Website: https://www.viberzi.com/copay-card
• Email: [email protected] (if you prefer email)
• Mail: as above. |
| Important reminder |
• Apply before you start Viberzi – you need the card before you pick up your first prescription.
• Keep your card handy – you’ll need to show it at the pharmacy to get the reduced copay.
• Keep your prescription handy – the card application will ask for your prescription details (brand name, dosage, pharmacy). |