Specialty Pharmacies 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®.

Specialty Pharmacies for UPTRAVI®
Specialty pharmacies that offer UPTRAVI®
The following specialty pharmacies can provide UPTRAVI® to your patients:
(Last updated March 2022)
For information on any changes to the list of UPTRAVI® specialty pharmacies, speak with a Janssen CarePath Care Coordinator today by calling 866-228-3546,Monday–Friday, 8 AM to 8 PM ET.
Medication delivery and refills
Let your patient know that the specialty pharmacy will call them to confirm delivery details of their medication. The specialty pharmacy will also supply refills as long as the prescriber verifies the continued prescription.