Activella (estradiol/norethindrone acetate)

Company: Novo Nordisk Pharmaceuticals, Inc.

Program name: Novo Nordisk Hormone Therapy Patient Assistance Program

Program address: PO Box 181640 Louisville, KY 40261

Phone number: 866-668-6336, ext #1

Fax number: 866-441-4190

Forms: novoho0333.pdf

Eligibility guidelines
and notes: The patient must have no prescription coverage for any medications and

Application process: With the patient's permission, anyone concerned can call for an application.

Application requirements: The doctor must fill out a section and sign the application.

Program details: A 5 month supply is sent to the doctor's office.

Last updated: 8/6/2008

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