Formulary Access for Victoza®

in Nevada

Indications and UsageVictoza® (liraglutide [rDNA origin] injection) is indicated as an adjunct to diet and exercise to improve glycemiccontrol in adults with type 2 diabetes mellitus.Because of the uncertain relevance of the rodent thyroid C-cell tumor findings to humans, prescribe Victoza® only topatients for whom the potential benefits are considered to outweigh the potential risk. Victoza® is not recommendedas first-line therapy for patients who have inadequate glycemic control on diet and exercise.In clinical trials of Victoza®, there were more cases of pancreatitis with Victoza® than with comparators. Victoza®

has not been studied sufficiently in patients with a history of pancreatitis to determine whether these patients are at increased risk for pancreatitis while using Victoza®. Use with caution in patients with a history of pancreatitis.Victoza® is not a substitute for insulin. Victoza® should not be used in patients with type 1 diabetes mellitus or for thetreatment of diabetic ketoacidosis, as it would not be effective in these settings.Victoza® has not been studied in combination with prandial insulin.

Important Safety InformationLiraglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors atclinically relevant exposures in both genders of rats and mice. It is unknown whether Victoza® causesthyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans, as human relevancecould not be ruled out by clinical or nonclinical studies. Victoza® is contraindicated in patients with apersonal or family history of MTC and in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Based on the findings in rodents, monitoring with serum calcitonin or thyroid ultrasound wasperformed during clinical trials, but this may have increased the number of unnecessary thyroidsurgeries. It is unknown whether monitoring with serum calcitonin or thyroid ultrasound willmitigate human risk of thyroid C-cell tumors. Patients should be counseled regarding the risk andsymptoms of thyroid tumors.

Please see additional Important Safety Information on back and accompanying Prescribing Information.Optum Rx - This document is intended for provider communication only and is not approved for Prescription Drug Plan member distribution.Formulary status information is based on the Centers for Medicare & Medicaid Services Web site. All coverage and updated information is validas of December 2012, and must be verified with plan sponsors as all information is subject to change without notice.

References: 1. Data on file. Novo Nordisk Inc., Princeton, NJ. 2. Victoza® [package insert]. Princeton, NJ: Novo Nordisk; 2012.Victoza® is a registered trademark of Novo Nordisk A/S. © 2012 Novo Nordisk Printed in the U.S.A. 0512-00009058-1 December 2012

Victoza® was studied in older patients.

No overall differences in the safety or effectiveness of Victoza®

(liraglutide [rDNA origin] injection) were observed between older adult patients and younger adult patients, but greater sensitivity of some older individuals cannot be ruled out.

Victoza® provides additional benefits:

Low rate of hypoglycemia

Indicated for use with basal insulin2

Can be taken once a day at any time, independent of meals

Important Safety Information (cont’d)Do not use in patients with a prior serious hypersensitivity reaction to Victoza® or to any of theproduct components. If pancreatitis is suspected, Victoza® should be discontinued. Victoza® should not be re-initiated ifpancreatitis is confirmed. When Victoza® is used with an insulin secretagogue (e.g. a sulfonylurea) or insulin serioushypoglycemia can occur. Consider lowering the dose of the insulin secretagogue or insulin to reduce the risk of hypoglycemia. Renal impairment has been reported post-marketing, usually in association with nausea, vomiting,diarrhea, or dehydration which may sometimes require hemodialysis. Use caution when initiating or escalating doses of Victoza® in patients with renal impairment. Serious hypersensitivity reactions (e.g. anaphylaxis and angioedema) have been reported during postmarketing use of Victoza®. If symptoms of hypersensitivity reactions occur, patients must stop takingVictoza® and seek medical advice promptly.There have been no studies establishing conclusive evidence of macrovascular risk reduction withVictoza® or any other antidiabetic drug.The most common adverse reactions, reported in ≥5% of patients treated with Victoza® and morecommonly than in patients treated with placebo, are headache, nausea, diarrhea, and anti-liraglutideantibody formation. Immunogenicity-related events, including urticaria, were more common amongVictoza®-treated patients (0.8%) than among comparator-treated patients (0.4%) in clinical trials.

Victoza® has not been studied in type 2 diabetes patients below 18 years of age and is not recommended for use in pediatric patients. There is limited data in patients with renal or hepatic impairment. In a 52-week monotherapy study (n=745), the adverse reactions reported in ≥5% of patients treated with Victoza® or ≥5% of patients treated withglimepiride were nausea (28.4% vs 8.5%), diarrhea (17.1% vs 8.9%), vomiting (10.9% vs 3.6%), constipation (9.9% vs 4.8%), upper respiratorytract infection (9.5% vs 5.6%), headache (9.1% vs 9.3%), influenza (7.4% vs 3.6%), urinary tract infection (6.0% vs 4.0%), dizziness (5.8% vs5.2%), sinusitis (5.6% vs 6.0%), nasopharyngitis (5.2% vs 5.2%), back pain (5.0% vs 4.4%), and hypertension (3.0% vs 6.0%).In a 26-week study (n=323) of Victoza® 1.8 mg and intensification with insulin detemir, the only adverse reaction reported in ≥5% of the patientstreated with Victoza® 1.8mg+metformin+insulin detemir and greater than in patients treated with Victoza® 1.8mg+metformin alone was diarrhea(11.7% vs 6.9%, respectively).Please see additional Important Safety Information on front and accompanying Prescribing Information.

Represents national formulary status. Provider communication only—not approved for prescription drug plan member distribution. Reference source based on CMS Web site(www.medicare.gov)—please verify with the plan sponsors on coverage and updated information. Intended as a guide only. Formulary status is subject to change. MedicarePart D data is on file with Novo Nordisk and current as of January 1, 2012. Effective date: December 01, 2012. Expiration date: December 31, 2012.Lower acquisition costs alone do not necessarily reflect a cost advantage in the outcome of the condition treated because there are other variables that affect relative costs.Multiple products within the same therapeutic class may be considered “preferred” or “lowest branded co-pay” and on the same tier.If you do not want to be included in future mailings or communications from Novo Nordisk, please call 1-877-744-2579 or send a brief note with your name and address to:Novo Nordisk at 100 College Road West, Princeton, NJ 08540.Needles are sold separately and may require a prescription in some states.

Health Plan1 Status1

Express Scripts National Preferred Formulary 2012 Lowest brand co-pay

SilverScript Lowest brand co-pay

CVS Caremark Medicare Part D Lowest brand co-pay

Humana Medicare/Part D Lowest brand co-pay with PA; Step - Any oral diabetes medication

Senior Dimensions Lowest brand co-pay with No Restrictions

Anthem Blue Cross and Blue Shield Part D Lowest brand co-pay