The Novo Nordisk Patient Assistance Program (PAP) encompasses our goal of continued commitment to people living with diabetes and the Novo Nordisk Triple Bottom Line. The Diabetes PAP provides free medicine to those who qualify. If approved, a free 120-day supply of medicine will be sent to the prescribing health care providers' office to be picked up at the patient's convenience. Novo Nordisk will automatically contact the health care provider 80 days later to approve the medication refill.

If you are a patient in need of assistance or know someone in need of assistance, follow these 3 simple steps to see if you qualify for free diabetes medication from Novo Nordisk: 1) Complete the “For Patient”, “Patient Signature”, and “Date” sections on the application 2) Gather proof of income 3) Take application and proof of income to your health care provider to complete the Health Care Practitioner section of your application. Patients and care givers can also obtain more information and access to the program by calling the Novo Nordisk Patient Assistance Program toll free at 866-310-7549. Patients can also obtain information by visiting If you are a health care professional and you want additional information about the Novo Nordisk Patient Assistance Program, have eligible patients who are not yet enrolled, or have patients who are enrolled and want additional information about their eligibility, please visit

How to Apply

Please either download the application below (if available) or go to the program website for more information on how to apply. Once you fill out your application, send it to the address on the application. Remember not to send program applications to PPA.

Product(s) Covered by Program

  • G

    • GlucaGen® Hypokit
  • L

    • Levemir® 10 mL vials
    • Levemir® FlexTouch® (5x3 mL)
  • N

    • Novolin® 70/30 10 mL vials
    • Novolin® N 10 mL vials
    • NovoLog® FlexPen® (5x3 mL)
  • T

    • Tresiba® FlexTouch U100
    • Tresiba® FlexTouch U200
    • Tresiba® U-100 vial
  • V

    • Victoza® 6 mg/mL 2 x 3mL
    • Victoza® 6 mg/mL 3 x 3mL