Xultophy Patient assistance program
Complete a free online enrollment application to find out if you’re eligible to pay only $49 per month for your Xultophy medication.Get started today
- Secure: Your personal and medical information is safe with us
- Convenient: We manage the whole process and we’re here to assist you
- Ongoing refills: We request your medication refills on your behalf
NiceRx works with your healthcare provider to help you access affordable medications directly from U.S. pharmaceutical companies.
An introduction to NiceRx(01:52)
Next steps after qualifying(00:38)
Uploading documents and billing(00:50)
SSN & billing information(00:33)
Medication delivery time(00:41)
How it works
Get started by filling out the online enrollment application to find out if you are eligible.
NiceRx verifies your eligibility for medication assistance and notifies you if you are qualified.
You may be required to submit further information and documents required by the pharmaceutical company which can be securely uploaded online.
Your application is created and sent to your doctor for signature. At this stage, you will be billed $49 and will not be billed again until you receive your first medication delivery.
Your application is sent to the pharmaceutical company. You will be billed again once you receive your medication. We handle the entire ordering process including requesting ongoing refills.
Your monthly Xultophy cost savings if eligible
If eligible for the Xultophy patient assistance program, you could make the following savings every month:
Avg. monthly price at
a US pharmacy
five 3ml pens of 100 units/ml $1,120.00 $49.00 $1,071.00
Am I eligible for the Xultophy patient assistance program?
To find out if you are eligible for the Xultophy patient assistance program, complete your online enrollment application with NiceRx. We review each enrollment application individually, but the main factors considered by most programs are:
How do I apply for the Xultophy patient assistance program?
Applying for the Xultophy patient assistance program is simple with NiceRx. Begin by completing the enrollment application online. You will need to tell us about any medications you’re taking, including Xultophy. We’ll also ask for details about your healthcare provider, your insurance plan, and your household income. This information is required by the pharmaceutical manufacturers that supply your medication.
Once we determine that you may be eligible for the Xultophy patient assistance program, we’ll handle the full enrollment process for you. And once enrolled in the program, we’ll also request your Xultophy medication refills on your behalf for up to 12 months.
Is NiceRx a Xultophy coupons provider?
NiceRx is not a Xultophy coupon, a Xultophy discount card, or a Xultophy copay card provider. We don’t offer printable Xultophy manufacturer coupons, Xultophy discounts, rebates, Xultophy savings cards, trial offers, or free Xultophy samples. NiceRx is a service provider that helps eligible individuals access the Xultophy patient assistance program.
Can NiceRx help me get Xultophy if I have insurance?
Yes, we may be able to help you if you have insurance. This includes if you have a high copay or coinsurance responsibility for Xultophy, or your insurance company won’t pay for your Xultophy prescription. We may even be able to help if you don’t have insurance. Apply online with NiceRx to find out more.
How much is Xultophy with insurance?
The cost of Xultophy with insurance will depend on your healthcare plan. Your pharmacist or healthcare provider will be able to calculate your copay with your current insurance.
How much does Xultophy cost without insurance?
Xultophy prices without insurance will vary by retailer, but as a guide, one Xultophy 100/3.6 pen will cost around $290.
What is Xultophy?
Xultophy is a prescription medicine given to adults with type 2 diabetes. It contains two medicines in one injection that can lower your blood glucose levels when used alongside exercise and changes to your diet.
The medication is made up of a long-acting insulin to help your cells absorb glucose from your blood, and an ingredient called liraglutide that makes your pancreas produce more insulin. You take Xultophy by injecting it under your skin (subcutaneous injection), using either a syringe or a pre-filled self-injecting pen. You usually inject Xultophy every 24 hours at the same time each day, as a single dose can lower your blood glucose as effectively as 4 insulin injections taken throughout the day.
Xultophy active ingredients
Xultophy contains two active ingredients called insulin degludec and liraglutide. They work in combination to help lower your blood glucose levels by adding insulin to your blood and stimulating your pancreas to make more insulin.
Insulin degludec is a man-made (synthetic) version of insulin. It works in the same way as the insulin your body naturally produces, by helping your cells absorb glucose from your blood. The only difference is that insulin degludec is a long-acting insulin that’s absorbed more slowly than human insulin, so it works for longer, over 24 hours.
Liraglutide is a type of diabetes medicine called a GLP-1 receptor agonist. It enters your pancreas and binds to the cells that produce insulin at sites called GLP-1 receptors. This causes the cells in your pancreas to release more insulin into your blood.
Xultophy side effects & Xultophy drug interactions
The most common side effects caused by Xultophy include:
- Feeling sick (nausea)
- A sore throat
- A runny or stuffy nose
- An increase in upper respiratory tract infections, like colds
- Increased levels of an enzyme called lipase in your blood that may show up in blood tests
In rare instances, Xultophy can cause more serious side effects, including:
- Thyroid tumors, including cancerous tumors
- Heart failure, if you take Lantus with other medications called TZDs (thiazolidinediones)
- Severe allergic reactions to the medication that can cause anaphylaxis
- Inflammation of your pancreas (pancreatitis), which can be severe, and in some cases, fatal
- Kidney problems, including kidney failure
- Gallbladder problems
- Very low blood sugar (hypoglycemia)
- Low potassium levels in your blood (hypokalemia)
Xultophy can interact with other medications, specifically:
- Thiazolidinedione medications (TZDs), taken to treat diabetes
- Any other diabetes medications
- Any medications containing liraglutide or another glucagon-like peptide 1 receptor agonist (GLP-1 receptor agonist)
- Any medications that contain alcohol
Xultophy warnings & precautions
Don’t take Xultophy if you’re having an episode of low blood sugar (hypoglycemia). As with all medications, Xultophy isn’t suitable for everyone. Specifically, don’t take Xultophy if you:
- Are allergic to the active ingredients insulin degludec or liraglutide
- Are allergic to any of the other ingredients in Xultophy
- Have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) – or if a family member has
- Have an endocrine system condition called multiple endocrine neoplasia syndrome type 2 (MEN 2) – or if a family member has
- Have diabetic ketoacidosis – a condition where high blood sugar causes high levels of ketones to build up in your body
- Have type 1 diabetes (Xultophy is for type 2 diabetes only)
- Are under 18 years of age
Talk to your doctor before taking Xultophy if you:
- Are taking any of the medications that could interact with Xultophy
- Have ever had an allergic reaction to a GLP-1 receptor agonist medication
- Have or have had any heart problems
- Have or have had any pancreas problems
- Have or have had any kidney problems
- Have or have had any liver problems
- Have any problems with your stomach, such as problems digesting food or slowed emptying of your stomach (gastroparesis)
- Are pregnant or are planning to become pregnant
- Are breastfeeding or are planning to breastfeed
*Qualifying persons may obtain medications directly from patient assistance programs without any out-of-pocket cost (or for less than $49 per medication). However, our monthly flat rate of just $49 per medication spares you the hassle of tracking down the different programs and filling out all the required paperwork for each program.
Enrollees enjoy a full-service solution, as NiceRx assists them and their physicians with the entire process. We prepare all required documents for the physician to sign, help enrollees manage all prescription refills, monitor eligibility criteria, and maintain enrollment.
**If you do not receive medications because you were determined to be ineligible for the prescription assistance by the applicable pharmaceutical companies and you have a letter of denial, we will refund any fees you paid toward medications for which you did not qualify to receive prescription assistance (“Refund”).
To receive a refund, you must send the letter of denial to us by fax to 888-517-7444, or by e-mail to [email protected] within 30 days of your receipt of such letter. The Refund is your sole and exclusive remedy for any fees you may wish to dispute.