Xeljanz®

In order to redeem this offer, patient must have a valid prescription for the brand being filled. A valid prescriber ID# is required on the prescription. Patient is not eligible if he/she is enrolled in any federal or state healthcare program with prescription drug coverage, such as Medicaid, Medicare, VA, DOD, TRICARE, or any similar federal or state health care program (each a government program), or where prohibited by law. Should you begin receiving prescription benefits from any federal, state, or government funded program at any time, you will no longer be eligible to participate in this program. Patients enrolled in a federal or state health care program may not use this program even if they elect to be processed as an uninsured (cash-paying) patient. Patients are also ineligible for this offer if they are Medicare-eligible and enrolled in an employer-sponsored group waiver health plan (EGWP) or government-subsidized prescription drug benefit program for retirees. This offer operates outside of any third-party insurance and is not valid for prescriptions covered or submitted for reimbursement, in whole or in part, under Medicare, VA, DoD, Tricare, or similar federal or state programs including any state pharmaceutical assistance program or commercial / private insurance. Medication filled prior to enrollment in this program will not be eligible for this coupon and cannot be reimbursed.

By redeeming this coupon, you (and anyone else acting on your behalf) agree not to seek reimbursement from any insurance plan for out-of-pocket costs for prescriptions purchased with this coupon. You also agree not to count the cost of prescriptions toward your deductible or true out-of-pocket costs. This offer does not include all Novo Nordisk products. This offer is valid only in the United States and its territories, unless prohibited by law, and may be redeemed at participating pharmacies. Cannot be combined with any other external savings, free trial, or similar offer for the specified prescription. Data related to your redemption of the coupon may be collected, analyzed, and shared with Novo Nordisk, for the purposes of administering and managing the program, and other purposes related to assessing the program. Data shared with Novo Nordisk will be aggregated and de-identified and will not identify you.

This program is not health insurance. This program is administered by GoodRx on behalf of Novo Nordisk. Novo Nordisk reserves the right to rescind, revoke, or amend this offer without notice at any time.

For the pharmacist: If you have any questions on how to apply the coupon information for the patient’s discount, please call 1-833-378-3672