Pharmacy Consent
Our pharmacy agrees to abide by the terms and conditions of the Saxenda Patient Program as detailed below:

  • Enrolled pharmacies will receive an opening order of one (1) unit of Saxenda® at time of launch in March 2016. There will be extended credit on this opening order and a full refund is available after 12 months if the pharmacy does not dispense this unit. The pharmacy will have stock holding of Saxenda® at all times.
  • Patients are to receive Saxenda® from the pharmacy at a price of no more than $387.00 inclusive of dispensing fees.
  • Timely access to patient information and added value including needles for the Saxenda® Pen. Patients who are enrolled in SaxendaCare™ are entitled to free needles via pharmacy redemption from Saxenda® Network Pharmacies.
  • A Saxenda® Program Patient Enrolment Form will be processed via the web portal eForm at each dispensing and a copy provided to the patient.
  • Your pharmacy will create a tailored one-page Saxenda® Patient Information leaflet (SmartForm PDF) which will explain some key quality use of medicine elements.

Our pharmacy will implement the program according to the Saxenda Patient Program Protocol.