For commercially insured patients, STAY ON TREMFYA®

Janssen Carepath Savings Program

Eligible patients pay per injection

with a $20,000 maximum program benefit per calendar year.

See full program requirements at Tremfya.JanssenCarePathSavings.com.

Patients will receive TREMFYA®at no cost until they receive insurance coverage approval.

See full program requirements at JanssenCarePath.com/Tremfya/Janssen-Link.

Both programs are unavailable to individuals who use any state or federal government-funded healthcare program to cover a portion of medication costs, such as Medicare, Medicaid, TRICARE, Department of Defense, or Veterans Administration.

These programs are for medication only. Terms expire at the end of each program year and may change.

Read about additional details in the Choose TREMFYA®, Get TREMFYA® Brochure.

For cost insurance information for different types of payers.

 

 

Coverage and support 
to help patients start
and stay on tremfya®

View ZIP code-specific coverage 
information using our lookup tool.

ACCESS FORMS

Here are all the forms you may need to help secure access to TREMFYA® for your patients.

Prescription Information and Enrollment Form

This form is the first step to understanding your patient’s insurance coverage and enrolling the patient in the So Simple Trial Program.

download-link

Business Associate Agreement

Complete this Business Associate Agreement one time only to allow you to request verification of patients’ insurance benefits without requiring individual patient authorization.

download-link

Patient Authorization

If no Business Associate Agreement is on file, you must secure patient authorization for each patient. Use this form or complete patient authorization on the Prescription Information and Enrollment Form. Janssen CarePath cannot accept any patient without an executed Business Associate Agreement or patient authorization on file.

download-link

Sample Letter of Exception

To document the request for a Payer to cover a nonformulary product or when step therapy through other treatments is required.

download-link

Sample Letter of Medical Necessity

Sample letter to communicate that TREMFYA® is medically appropriate and necessary and should be covered and reimbursed.

download-link

Sample Letter of Appeal

To document and request a Payer review a denied coverage determination for TREMFYA®, such as prior authorization or exception request denials.

download-link

TREMFYA® Prior Authorization Checklist

Reminders and tips when completing prior authorizations for your patients.

.