Mounjaro®
2,5 KwikPen 10 mg/2,4 ml, 5 KwikPen 20 mg/2,4 ml, 7,5 KwikPen 30 mg/2,4 ml en 10 KwikPen 40 mg/2,4 ml | KwikPen
General information
The pharmacist has dispensed Mounjaro KwikPen for the indication Diabetes Mellitus type 2 to the patient. The health insurer will not reimburse the cost of this prescription in full. The producer of this medicine has therefore instructed TBR Nederland to reimburse to the patient the Personal Contribution charged.
| Dose | 2,5 KwikPen 10 mg/2,4 ml, 5 KwikPen 20 mg/2,4 ml, 7,5 KwikPen |
| 30 mg/2,4 ml en 10 KwikPen 40 mg/2,4 ml | |
| Type | KwikPen |
| Active ingredient | TIRZEPATIDE |
Reimbursement
Conditions
The Personal Contribution for Mounjaro KwikPen for the indicatie Diabetes Mellitus type 2 charged to the patient by the health insurer, is eligible for full reimbursement from 11 November 2024 to a maximium of € 250,- per patient per year. Therefore, the patient can submit a claim with TBR Nederland.
There is no reimbursement for Personal Contributions for the indication Obesity.
The reimbursement for Mounjaro 2,5 mg dose is limited to one pack per patient.
Who can submit a claim
Patients or their carer can submit a claim for the Personal Contribution amount they paid for Mounjaro KwikPen for the indication Diabetes Mellitus type 2 online. Pharmacists cannot submit claims on behalf of patients for this medicine.
From when till when can you submit a claim
For the Reimbursement Scheme of this medicine no closing date has been determined yet.
Submit a claim online
Patients can claim online and will receive their reimbursement within 5 working days.
Submit a claim by post
Patients can claim by post and will receive their reimbursement within 15 working days.
Please mail the Claim Form and attachments to:
TBR Nederland
Postbus 8011
1180 LA Amstelveen
Need some help?
If you need any assistance please read our Frequently Asked Questions.
Still does not work? Please contact our Servicedesk via e-mail or call the Mounjaro® service-number 088-0026796.
PP-TR-NL-0165
Check your medicine expenses
Quickly check the maximum contribution you have to pay for your medicine
