Victoza - Anybody figure out a way to get their ins. to help with purchasing it?

sugartwin01
By sugartwin01 Latest Reply 2014-03-15 13:37:40 -0500
Started 2010-08-13 08:36:55 -0500

My MD Dr. wrote a RX for Victoza… my insurance turned me down!
Then I went to my boss's Diabetic Specialist… because she was getting it thru RX from him… Well, when I went to the specialist.. I returned to the pharmacy… to be told AGAIN that CVS DOES cover it.. BUT THAT VICTOZA DOES NOT SELL IT IN THE QUANITY THAT THE INSURANCE COMPANY WILL COVER IT FOR! this is nutz!… My boss was unclear about her insurance… I was under the impression that we share the same board of ed policy.. but evidently.. she has a different set up?… so the end result? I'm can't afford to purchase it! I was wondering if any body had found a way to resolve that issue?


18 replies

Mr Victoza
Mr Victoza 2014-03-15 13:37:40 -0500 Report

If you need Victoza I know a way you can get it for cheap. I can get it through my insurance, they pay 75% of it. I pay about $130.00 a month. I get a 3 pack every month. 3 pens will get you a 1.8mg dose daily. This will cost you about $75.00 and there is no shipping cost. If you need more information, please contact me at stnicholascenter@gmail.com small.

Jolene108
Jolene108 2013-11-19 11:17:30 -0600 Report

I have been on Victoza for 18 mos. My insurance carrier (EXPRESS SCRIPTS) just notified me that they will no longer cover it. (thru the pharmacy nor mail order). I googled " Express Scripts Victorza" and found many business postings about ES not renewing their contract with Norvo…I have contacted Norvo to see what they can due for me until I qualify for Medicare in 2016. Medicare covers Victoza.

djm603
djm603 2011-07-31 14:01:07 -0500 Report

My insurance denied it and then my Doctor wrote a letter appealing it and they approved it.

Roy531
Roy531 2010-08-13 09:03:52 -0500 Report

If it is like what we have here, we have several insurance companies to chose from, I choose not to use the one for the state because I got tired of having to pay $200.00 for my lab work so was able to change to a different provider that will cover it. We renew our insurance every year and they send us a book showing providers and what they cover. Of course sometime have to pay more for the coverage but it isn't that much. I work for a school district in Okla.

Roy

sugartwin01
sugartwin01 2010-08-13 09:08:52 -0500 Report

We use to have two… then I think we disolved to just B/C & B/Shield… fall is coming up.. and we should be able to change.. if there is anything to change to! (enrollment time) So.. what I've gotten from your post is… I should contact Victoza/my pharmacy/ who ever has connections with them… and just ask.. what ins. companies will play ball with them?… so dissapointed in B/C & B/S… with this CVS Rx Ins!

Roy531
Roy531 2010-08-13 10:36:12 -0500 Report

Insurance companies have a list of drugs they will cover, always have to pay more if not a generic, but that's just the nature of the beast. I don't think the pharmacy will know what insurance companies will cover unless they deal with them with another customer, they also will have a formulary that shows what they cover. I use Pacificare, they have gone up on the deductable, everything gose up but your wages. But I think it is still worth it cause the cover the lab work. Take to somebody else that might have the other insurance, they might be able to go to their web site and see what meds are covered.

donutman
donutman 2010-08-14 22:11:59 -0500 Report

I have BS/BS of Texas with drug coverage with CVS\Caremark. I am on 1.2 per day and they have covered it since I started taking it about 3 months ago. One good side effect, I lost 50 pounds in about 3 months. Down from 250 to 200.

sugartwin01
sugartwin01 2010-08-15 12:22:13 -0500 Report

I was wondering… did your MD or your specialist write the script for Victoza? Did you automacitally start on 1.2 per day? or did your doctor have to rewrite the amount of dosage over and over.. until CVS finally agreed to a dosage amount? It's good to finally talk to somebody that has the same coverage that I have!…So.. if I'm to understand this correctly… I should ask my MD to write a RX for 1.2 dosage of Victoza… since I've been told I'm a good candidate for Victoza… I truly think it could help me with controling my sugar blood levels. I look forward to more input from you!

kdroberts
kdroberts 2010-08-17 08:37:50 -0500 Report

All your doctor has to do is write a script for 0.6, 1.2 or 1.8 per day. The pharmacy will put through a claim for the closest box, 2 or 3 pens, and the insurance will pay per your scheduled benefits, either a flat amount or a % of the cost the pharmacy sells it for.

1.2 is just a standard starting amount that may need to be adjusted up or down depending on how it works.

I think you need to pick up your prescription, see what it says and then either ask for a new one or take it to a different pharmacy.

kdroberts
kdroberts 2010-08-13 09:01:04 -0500 Report

Sounds like there is some insurance confusion. Have you called up the insurance company and asked which pharmacies they cover, how victoza is covered and if they offer a mail order plan? What quantity are they telling you that your insurance covers? It comes in boxes of 2 and 3 pens, both 3ml. Sometimes they are sold as 3ml or 9ml boxes. The dose that you take will be different, could that be where the confusion is? It may also be that you need prior authorization for it and meet certain eligibility requirements.

sugartwin01
sugartwin01 2010-08-13 09:13:26 -0500 Report

When my reg. MD office called my ins. company… the office was informed… for the ins. to cover Victoza… the pens would have to have about 1/2 of the medication squeezed out!… … that was when they were attempting to get the authorization for me!
The pharmacy had orig. attempted to push it thru.. and when the ins. refused it.. the pharmacy contacted my Doctor office to tell them Victoza is only covered in smaller quantity.. but… then the dr's office said that the quanity the ins. would cover.. is NOT supplied by Victoza! NUTZ NUTZ NUTZ

kdroberts
kdroberts 2010-08-13 09:28:59 -0500 Report

Victoza is a drug, it's made by Novo Nordisk. Most prescription insurance plans have a mail order pharmacy who will dispense 90 day supplies at a reduce cost. It's more up front but usually works out less per month. What dose does your doctor want you to take? Is Victoza even on your insurance companies formulary? The insurance will cover medication based on the dose prescribed. If your doctor prescribes 0.6mg per day you will get a 2 pen box for example even though you would only need a little over 1 pen per month. I don't get the squeezing out comment, if you have more left at the end of the month you just keep using it. At the lowest dose you would never have have an expired amount of the medication left unless you missed some doses during the month. You could always try another pharmacy, some pharmacists and pharmacy techs do not really understand insurance billing and can easily mess up a claim.

Victoza and Byetta are different versions of the same thing so you have the same sort of side general effects with both, sickness being one of them.

sugartwin01
sugartwin01 2010-08-13 09:56:33 -0500 Report

I sent an email to Novo Nordisk… just now! I understand that Victoza is a drug.. hence the Pharmacy. The Dr.'s office has explained that it's not the pharmacy's fault that the prescription was refused by the ins. company to cover. - I know it doesn't make sense that the ins. company told my Dr's office that there amount in the pens are too great… even though I was shown how to take the dosage in small increments. The Dr.'s office has said it doesn't make sense! I don't have the dosage amount in front of me… as these prescriptions were written back in the Spring… I discovered that I have Diabetes in Feb 2010. When my principal/boss made me aware of how great Victoza had been working for her… that's when I started to research and desire the opportunity to utilize the drug as well. My boss would take her Victoza before going to bed at night.. so that she would not be aware of the sickness. The specialist thinks alot of CVS Ins.'s issues are wrapped around the fact that Victoza was just released recently… and may still consider it experimental. Is this not America? If Victoza has cleared the necessary boards… and other Diabetics are allowed to utilize it… and my specialist agrees that I'm an EXCELLENT candidate for Victoza… why can't I get the same reduced price as others?

kdroberts
kdroberts 2010-08-13 10:04:17 -0500 Report

You can pay the cash price for it and have no problems at all but if you want insurance to cover part of that cost you have to go by what your policy covers or does not cover and how it covers it. Personally I think the issue lies with the pharmacy messing things up and I would take your prescription elsewhere to see what happens.

darlene1956
darlene1956 2010-08-17 07:31:23 -0500 Report

I have been to 2 pharmacies and the second on could get $60.00 out of my bc/bs ins. The reason I keep getting on why they don't want to cover it is because it is so new. Now the cost on it is way too high ($276.00 per month, 1 pen). So when the new pen for once a week usage comes out then Victoza cost will go down. The ins companies and companies like Norvo are in cahoots. They are in for the money and don't give a darn about your blood sugar amounts.

darlene1956
darlene1956 2010-08-17 07:33:46 -0500 Report

Edit doesn't work…but anyway I have been on Victoza for approx. 6 months and I have lost weight and my A1C is 6.7 wooohooo!

sugartwin01
sugartwin01 2010-08-13 09:16:58 -0500 Report

A MAIL ORDER PLAN? I'm not familiar with that? So I should look and see if Victoza offers that? The specialist thought that the reason it was turned down… was perhaps.. since Victoza is new… that they may want me to go on Byetta first.. But my mom went on Byetta and quickly off of it..she told me it made her soooo sick!… so I really don't wish to go on something.. to find out it was a total waste of money!.. and then perhaps find out they still don't allow me on Victoza!…

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