Sign up for the ZEGALOGUE® (dasiglucagon) injection Co-Pay Savings Card

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If eligible, you may pay as little as $25 for up to 2 ZEGALOGUE devices per fill

Eligible patients may pay as little as $25 for up to 2 ZEGALOGUE devices per fill. Please note that patients insured by any federal health care program like Medicare, Medicare Advantage, Medicare Part D, Medicaid, Managed Medicaid, Veterans Affairs (VA), Department of Defense (DOD), or TRICARE are not eligible for the ZEGALOGUE Co-Pay Savings Card Program.

Please be aware that the information you provide below will be used by companies working with Zealand Pharma for the purposes of evaluating and continually confirming your eligibility for the ZEGALOGUE Co-Pay Savings Card. In addition, Zealand Pharma, and companies working with Zealand Pharma, will have access to the information you provide and the information that is obtained through your use of the co-pay card during your participation in this program and other optional programs you sign up for. Please review Zealand Pharma’s Privacy Policy available here.

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What is ZEGALOGUE?

ZEGALOGUE (dasiglucagon) injection is a prescription medicine used to treat very low blood sugar (severe hypoglycemia) in people with diabetes aged 6 years and older. It is not known if ZEGALOGUE is safe and effective in children under 6 years of age.

IMPORTANT SAFETY INFORMATION

Do not use ZEGALOGUE if you:

  • have a tumor called pheochromocytoma in the gland on top of your kidneys (adrenal gland)
  • have a tumor called insulinoma in your pancreas.
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What is ZEGALOGUE?

ZEGALOGUE (dasiglucagon) injection is a prescription medicine used to treat very low blood sugar (severe hypoglycemia) in people with diabetes aged 6 years and older. It is not known if ZEGALOGUE is safe and effective in children under 6 years of age.

IMPORTANT SAFETY INFORMATION

Do not use ZEGALOGUE if you:

  • have a tumor called pheochromocytoma in the gland on top of your kidneys (adrenal gland).
  • have a tumor called insulinoma in your pancreas.

Before using ZEGALOGUE, tell your healthcare provider about all of your medical conditions, including if you:

  • have a tumor in your pancreas.
  • are allergic to dasiglucagon, or any other ingredients in ZEGALOGUE.
  • have not had food or water for a long time (prolonged fasting or starvation).
  • have adrenal insufficiency.
  • have low blood sugar that does not go away (chronic hypoglycemia).
  • are pregnant or plan to become pregnant.
  • are breastfeeding or plan to breastfeed. It is not known if ZEGALOGUE passes into your breast milk. You and your healthcare provider should decide if you can use ZEGALOGUE while breastfeeding.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

How should I use ZEGALOGUE? 

  • Read the detailed Instructions For Use that come with ZEGALOGUE.
  • Use ZEGALOGUE exactly how your healthcare provider tells you to use it.
  • Make sure your caregiver knows where you keep your ZEGALOGUE and how to use ZEGALOGUE the right way before you need it.
  • Your caregiver must act quickly. Having very low blood sugar for a period of time may be harmful.
  • Your healthcare provider will tell you how and when to use ZEGALOGUE.
  • After giving ZEGALOGUE your caregiver should call for emergency medical help right away.
  • Once you are able to safely consume food or drink, your caregiver should give you a fast-acting source of sugar (such as fruit juice) and a long-acting source of sugar (such as crackers with cheese or peanut butter).
  • If you do not respond to treatment after 15 minutes, your caregiver may give you another dose, if available.
  • Tell your healthcare provider each time you use ZEGALOGUE. Your healthcare provider may need to change the dose of your other diabetes medicines.

What are the possible side effects of ZEGALOGUE?

ZEGALOGUE may cause serious side effects, including:

  • high blood pressure. ZEGALOGUE can cause high blood pressure in certain people with tumors in their adrenal glands.
  • low blood sugar. ZEGALOGUE can cause certain people with tumors in their pancreas called insulinomas to have low blood sugar.
  • serious allergic reaction. Call your healthcare provider or get medical help right away if you have a serious allergic reaction including: rash, difficulty breathing, low blood pressure (hypotension).

The most common side effects of ZEGALOGUE include: in adults: nausea, vomiting, headache, diarrhea, and injection site pain; in children: nausea, vomiting, headache, and injection site pain. These are not all the possible side effects of ZEGALOGUE.

Please see Full Prescribing Information, including Patient Information.

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The information in this section of ZEGALOGUE.com/hcp is intended for US healthcare professionals only.

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TERMS AND CONDITIONS
Patient Instructions: The ZEGALOGUE® (dasiglucagon) injection Co-Pay Savings Card Program is ONLY valid for patients with commercial (private) insurance. In order to redeem this offer, you must have a valid prescription for ZEGALOGUE and you may not be enrolled in a state or federally funded prescription benefit program, including, but not limited to, Medicare (Parts A, B, C, or D), Medicaid (including Managed Medicaid), Veterans Affairs (VA), Department of Defense (DOD), or TRICARE. You are responsible for the first $25 and the card pays the remainder per prescription, up to a maximum of 12 fills per calendar year. Follow instructions provided by your doctor. This offer may not be redeemed for cash. By using this offer, you are certifying that you meet the eligibility criteria and will comply with the terms and conditions described in the Restrictions section below, including that you will not seek reimbursement for any part of the benefit received through this offer from any third-party payer, including any health savings, flexible spending, or other healthcare reimbursement account. Patients with questions about the offer should call 1-877-501-ZEGA (9342). THIS OFFER IS NOT INSURANCE.

Pharmacist: As a condition of payment, when you apply this offer, you are certifying that you have not submitted a claim for reimbursement under any federal, state, or other governmental programs including, without limitation, Medicare, Medicaid, VA, DOD, or TRICARE, for this prescription and will not seek reimbursement from health insurance or any third party for any part of the benefit the patient receives through this program. Participation in this program must comply with all applicable laws and regulations as a pharmacy provider. By participating in this program, you are certifying that you will comply with the terms and conditions described in the Restrictions section below.

Pharmacist Instructions for a Patient With an Eligible Third-Party Payer: Submit the claim to the primary Third-Party Payer first, then submit the balance due to CHANGE HEALTHCARE as a Secondary Payer COB (coordination of benefits) with patient responsibility amount and a valid Other Coverage Code, (e.g., 8). The patient is responsible for the first $25 and the card pays the remainder per prescription, up to 12 fills per calendar year. Reimbursement will be received from CHANGE HEALTHCARE.

A valid Other Coverage Code is required. For any questions regarding CHANGE HEALTHCARE online processing, please call the Help Desk at 1-800-422-5604.

Restrictions: This offer is valid in the United States. This offer is not valid for prescriptions reimbursed under Medicaid, a Medicare drug benefit plan, VA, DOD, TRICARE, or other federal or state health programs (such as medical assistance programs). If the patient is eligible for drug benefits under any such program or is Medicare-eligible and enrolled in employer-sponsored group waiver health plans or government-subsidized prescription drug benefit programs for retirees, the patient cannot use this offer. By using this offer, the patient and pharmacist certify that they will comply with any terms or requirements imposed on patients or providers by the health insurance to notify the health insurance plan of the existence and/or value of this offer. This offer is not valid for patients under 6 years of age. It is illegal to (or offer to) sell, purchase, or trade this offer. This offer is not transferable and is limited to one offer per person. Not valid if reproduced. Void where prohibited by law. This is not insurance. Program managed by ConnectiveRx on behalf of Zealand Pharma. The parties reserve the right to rescind, revoke, or amend this offer without notice at any time.

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Please select the quantity of savings cards you would like to download. 

Each card has a unique ID number.
Please do not make copies.

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The patient does not meet eligibility requirements for the ZEGALOGUE® (dasiglucagon) injection Co-Pay Savings Card.

For more information, please contact Zealand Pharma ConnectedCare at 1-877-501-ZEGA (9342), Monday-Friday, am to 8 pm ET.