For chronic weight management in adult patients with a BMI >30 kg/m2, or >27 kg/m2 with one or more weight-related comorbidities, as an adjunct to a reduced-calorie diet and increased physical activity. Click for Limitations of Use.

Streamline the Coverage and Reimbursement Process


1. Confirm patient coverage
Anti-obesity medication coverage is different from what you may be used to. Similar to smoking cessation or prescription vitamins, an employer decides whether or not to add the additional coverage to its base plan. Click below to find out if your patient is covered. Your patient’s pharmacy prescription card information will be required.
 


 

Watch how to confirm coverage for Saxenda®


Insurance doesn’t cover Saxenda®?

If a patient’s insurance plan doesn’t include Saxenda®, you can help appropriate patients gain access by providing coverage request documentation that your patients can bring to their human resources department. Download this sample coverage request letter as a guide for what you may write to a patient’s HR benefits department.


2. Initiate the prior authorization (PA) process

Once coverage is confirmed, PAs may be necessary for some patients. For Saxenda®, PAs often only require your patient’s name and BMI in order to confirm the appropriate patient is receiving the medication. You can complete the form in your office, or initiate the PA process online using the Prior Authorization Support System (PASS) or CoverMyMeds®.

Prior Authorization Support System (PASS)
PASS is a system designed to help verify patient insurance eligibility and streamline the prior authorization process for prescribed products and services. Here’s how it works:

  • First, submit authorization form for processing
  • Next, PARx Solutions submits the request on an appropriate health plan form and manages the request process on your behalf
  • Once complete, PARx Solutions provides you with the outcome of the request, and your office can monitor the status throughout the process
     


If you have questions or require assistance, please email info@PARxSolutions.com or call PARx Solutions directly at 1-866-725-PARx (7279).


CoverMyMeds®
Another option is to submit prior authorization requests for Saxenda® through CoverMyMeds®. Here’s how it works:

  • First, request the prior authorization via the Web, electronic health record, or clinical system—or access a pharmacy-initiated prior authorization via Web or fax
  • Next, fill in the prior authorization form with pertinent medical information, sign, and fax or submit to health plan for approval
  • Once complete, you’ll receive approval or denial via fax or through the CoverMyMeds® dashboard
     


For more information, please email info@covermymeds.com or call CoverMyMeds® directly at 1-866-452-5017.


3. Write the prescription and give patients support
Once you check that your appropriate patient is covered:

  • Give your patient the Saxenda® prescription and needles prescription (if required)
  • Give your patient a Saxenda® Sample Kit, which includes a Saxenda® Savings Card
  • Direct your patient to Saxenda.com to activate a Saxenda® Savings Card. Be sure to remind patients to activate their Savings Card before pharmacy pickup
  • Recommend your patient enroll in SaxendaCare®

Want a copy of this 3-step process?



Selected Important Safety Information

WARNING: RISK OF THYROID C-CELL TUMORS
Liraglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures in both genders of rats and mice. It is unknown whether Saxenda® causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans, as the human relevance of liraglutide-induced rodent thyroid C-cell tumors has not been determined. Saxenda® is contraindicated in patients with a personal or family history of MTC and in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk of MTC with use of Saxenda® and inform them of symptoms of thyroid tumors (eg, a mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with Saxenda®.

Indications and Usage

  • Saxenda® (liraglutide) injection 3 mg is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adult patients with an initial body mass index (BMI) of 30 kg/m2 or greater (obesity) or 27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbid condition (eg, hypertension, type 2 diabetes mellitus, or dyslipidemia)

Limitations of Use

  • Saxenda® is not indicated for the treatment of type 2 diabetes
  • Saxenda® and Victoza® both contain the same active ingredient, liraglutide, and therefore should not be used together. Saxenda® should not be used in combination with any other GLP-1 receptor agonist
  • Saxenda® has not been studied in patients taking insulin. Saxenda® and insulin should not be used together
  • The effects of Saxenda® on cardiovascular morbidity and mortality have not been established
  • The safety and efficacy of Saxenda® in combination with other products for weight loss, including prescription drugs, over-the-counter drugs, and herbal preparations, have not been established
  • Saxenda® has not been studied in patients with a history of pancreatitis

Important Safety Information (cont'd)

Contraindications

Saxenda® is contraindicated in:

  • Patients with a personal or family history of MTC or MEN 2

  • Patients with a prior serious hypersensitivity reaction to liraglutide or to any of the product components

  • Pregnancy

Warnings and Precautions

  • Risk of Thyroid C-cell Tumors: If serum calcitonin is measured and found to be elevated, the patient should be further evaluated. Patients with thyroid nodules noted on physical examination or neck imaging should also be further evaluated
  • Acute Pancreatitis: Based on spontaneous postmarketing reports, acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, has been observed in patients treated with liraglutide. After initiation of Saxenda® observe patients carefully for signs and symptoms of pancreatitis (including persistent severe abdominal pain, sometimes radiating to the back and which may or may not be accompanied by vomiting). If pancreatitis is suspected, Saxenda® should promptly be discontinued and appropriate management should be initiated. If pancreatitis is confirmed, Saxenda® should not be restarted
  • Acute Gallbladder Disease: Substantial or rapid weight loss can increase the risk of cholelithiasis; however, the incidence of acute gallbladder disease was greater in patients treated with Saxenda® than with placebo even after accounting for the degree of weight loss. If cholelithiasis is suspected, gallbladder studies and appropriate clinical follow-up are indicated
  • Risk of Hypoglycemia with Concomitant Use of Anti-Diabetic Therapy: When Saxenda® is used with an insulin secretagogue (eg, a sulfonylurea) serious hypoglycemia can occur. Consider lowering the dose of the insulin secretagogue to reduce the risk of hypoglycemia. Monitor blood glucose parameters prior to starting Saxenda® and during Saxenda® treatment in patients with type 2 diabetes mellitus
  • Heart Rate Increase: Mean increases in resting heart rate of 2 to 3 beats per minute (bpm) were observed with routine clinical monitoring in patients treated with Saxenda® compared to placebo in clinical trials. Heart rate should be monitored at regular intervals consistent with usual clinical practice. Patients should inform healthcare providers of palpitations or feelings of a racing heartbeat while at rest during Saxenda® treatment. For patients who experience a sustained increase in resting heart rate while taking Saxenda®, Saxenda® should be discontinued
  • Renal Impairment: In patients treated with GLP-1 receptor agonists, including Saxenda®, there have been reports of acute renal failure and worsening of chronic renal failure, usually in association with nausea, vomiting, diarrhea, or dehydration, which may sometimes require hemodialysis. Use caution when initiating or escalating doses of Saxenda® in patients with renal impairment
  • Hypersensitivity Reactions: Serious hypersensitivity reactions (eg, anaphylaxis and angioedema) have been reported during postmarketing use of liraglutide. If a hypersensitivity reaction occurs, patients should stop taking Saxenda® and promptly seek medical advice
  • Suicidal Behavior and Ideation: In the Saxenda® clinical trials, 9 (0.3%) of 3,384 patients treated with Saxenda® and 2 (0.1%) of the 1,941 with placebo reported suicidal ideation; one of the patients treated with Saxenda® attempted suicide. Patients treated with Saxenda® should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. Discontinue Saxenda® in patients who experience suicidal thoughts or behaviors. Avoid Saxenda® in patients with a history of suicidal attempts or active suicidal ideation

Adverse Events

  • The most common adverse reactions, reported in ≥5% are: nausea, hypoglycemia, diarrhea, constipation, vomiting, headache, decreased appetite, dyspepsia, fatigue, dizziness, abdominal pain, and increased lipase

Drug Interactions

  • Oral Medications: Saxenda® causes a delay of gastric emptying, and thereby has the potential to impact the absorption of concomitantly administered oral medications. Monitor for potential consequences of delayed absorption of oral medications concomitantly administered with Saxenda®

Use in Specific Populations

  • There are no data on the presence of liraglutide in human breast milk; liraglutide was present in the milk of lactating rats
  • Safety and effectiveness of Saxenda® have not been established in pediatric patients. Saxenda® is not recommended for use in pediatric patients
  • Saxenda® slows gastric emptying. Saxenda® has not been studied in patients with preexisting gastroparesis

Please click here for Prescribing Information.