Complete the Prescription Process for 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®.

Complete the Prescription Process for UPTRAVI®
Register Today for PATHwatch® for 24-hour Online Access to Support Your Patients
With a PATHwatch® account, you can:
- Complete the Prescription and Statement of Medical Necessity (PSMN) form electronically and submit it instantly to Janssen CarePath for processing
- Set up a patient dashboard with real-time updates for patients on Janssen oral PAH products
- Access critical details that affect enrollment and access history
- Get centralized storage for enrollment and reimbursement documents
- Receive real-time alerts on pending paperwork or missing information
- Easily track and monitor therapy shipments
- Search, sort, and filter patients
- Quick view of patient shipments and prior authorization status for Janssen oral PAH products
Or You Can Download Faxable Forms Below
Patient Authorization Form (en español)