Helping Patients Afford UPTRAVI®
- Janssen CarePath Oral PAH Savings ProgramEligible patients using commercial or private insurance can save on out-of-pocket-costs for UPTRAVI®.
- Janssen CarePath Resource GuideA comprehensive summary of support tools for your office to help patients start and stay on treatment.
- Patient Affordability OptionsDiscover options that can make UPTRAVI® more affordable for your patients.
- Patient Authorization FormA form for patients to allow their providers, insurers, and Janssen to share health information about them.
Patient Authorization Form (en español) - Patient Authorization Form (en español)A form for patients to allow their providers, insurers, and Janssen to share health information about them.
- Prior Authorization TipsA list of items and information that may be needed to obtain a coverage decision from an insurer.
- Sample Letter of AppealA template to send to patients' insurance companies to help get patients on treatment.
- Sample Statement of Medical NecessityA template that you can fill out and submit to a patient’s health insurance provider. You may use it to explain why UPTRAVI® is medically necessary for your patient.
- Steps to Getting Your MedicineA patient-friendly guide to the verification and delivery process.
Steps to Getting Your Medicine (en español) - Steps to Getting Your Medicine (en español)A patient-friendly guide to the verification and delivery process.
- UPTRAVI® Dose Adjustment Phase GuideA patient guide that highlights the important steps and information about titration with UPTRAVI®.
- UPTRAVI® Prescription and Statement of Medical Necessity (PSMN)Complete and submit this form first to get your patient started on UPTRAVI®.
- UPTRAVI® Prescription and Statement of Medical Necessity (PSMN)—For Veterans Affairs Patients OnlyComplete and submit this form first to get your Veterans Affairs patient started on UPTRAVI®.

Helping Patients Afford UPTRAVI®
Select your patient’s coverage status for relevant resources.
For Patients with Commercial or Private Insurance
There is a limit to savings each year. Savings may apply to co-pay, co-insurance, or deductible.
Patients may participate without sharing their income information.
We provide cost support directly to patients through the Janssen CarePath Oral PAH Savings Program. This benefit is intended to help eligible patients afford their out-of-pocket obligations as set by their health plans. The cost support is meant solely for patients—not health plans and/or their partners.
If your patients are having any difficulty accessing cost support through the Janssen CarePath Oral PAH Savings Program, please have them contact us at 866-228-3546.
In addition to the Janssen CarePath Oral PAH Savings Program, here are some independent programs that may be right for your patients.
For Patients with Government Coverage
Even if your patients have government coverage like Medicare, we can identify programs that may help them afford their medications. Here are some independent programs that may be right for them.
- Pay their monthly premiums
- Reduce or eliminate their deductible
- Reduce or eliminate their co-insurance and co-payments
- Have no gap in coverage
For Patients with No Insurance Coverage
If your patients need help with drug costs, we can identify programs that may help them afford their medications.
Here are some programs that are not offered by Janssen. Each program has its own eligibility rules.
Take a look and see which ones may be right for your patients.
There is a limit to savings each year. Savings may apply to co-pay, co-insurance, or deductible.
Patients may participate without sharing their income information.
We provide cost support directly to patients through the Janssen CarePath Oral PAH Savings Program. This benefit is intended to help eligible patients afford their out-of-pocket obligations as set by their health plans. The cost support is meant solely for patients—not health plans and/or their partners.
If your patients are having any difficulty accessing cost support through the Janssen CarePath Oral PAH Savings Program, please have them contact us at 866-228-3546.
In addition to the Janssen CarePath Oral PAH Savings Program, here are some independent programs that may be right for your patients.
- Pay their monthly premiums
- Reduce or eliminate their deductible
- Reduce or eliminate their co-insurance and co-payments
- Have no gap in coverage