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.

 

 

TREMFYA® START HERE RESOURCES

Enroll your patients in the TREMFYA® So Simple Trial Program to provide your patients their first dose of TREMFYA® by:

  1. Submitting the following to Janssen CarePath (through the fax number or mailing address listed on the Prescription Enrollment Form):
    • The fully completed and signed Prescription Enrollment Form (Section 4 refers to the So Simple Trial Program) and Patient Authorization Form (unless executed Business Associate Agreement [BAA] is on file)
    • A completed and signed Letter of Medical Necessity to establish the requirement that TREMFYA® is medically appropriate and necessary and should be covered and reimbursed
    • A completed and signed Prior Authorization Form
  2. Informing your patient that Wegman’s Specialty Pharmacy will contact them with this number (866-889-5660 WEGMANS SPCLTY) to receive consent

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.

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Sample Letter of Medical Necessity

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

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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.

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TREMFYA® Prior Authorization Checklist

Reminders and tips when completing prior authorizations for your patients.

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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.

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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.

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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.

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OTHER RESOURCES

The Johnson & Johnson Patient Assistance Foundation, Inc. (JJPAF) is an independent, nonprofit organization that is committed to helping eligible patients without insurance coverage receive prescription products donated by Johnson & Johnson operating companies. To see if they might qualify for assistance, please have your patient contact a JJPAF program specialist at 800-652-6227 (Monday–Friday, 9:00 AM to 6:00 PM ET) or visit the foundation website at JJPAF.org.