Publish Date: 
Wed, 11/18/2020 - 07:11

Janssen CarePath can:

  • Review your health plan benefits to help answer questions you may have about insurance coverage for UPTRAVI®
  • Identify options that may help make UPTRAVI® more affordable, if needed
  • Connect you with a dedicated PAH Companion* for one-on-one educational conversations and support
  • Identify and coordinate with a specialty pharmacy to arrange shipment of your Janssen medication

*The PAH Companion Program is limited to education about your Janssen therapy, its administration, and/or PAH. It is intended to supplement your understanding of your therapy, and does not provide medical advice or replace a treatment plan from your doctor, nurse, or healthcare team.

Getting Started with UPTRAVI®

UPTRAVI® is delivered by a specialty pharmacy—it's not something that's kept in stock at your local retail pharmacy. The following is a typical process when starting out with UPTRAVI®, though your experience may vary.

    • Prescription Prescription

      Your healthcare provider prescribes UPTRAVI®.

      • Your healthcare team will review important information about UPTRAVI® with you
      • They can help you enroll with Janssen CarePath
      • Your prescription will be sent to a specialty pharmacy
      • Your healthcare provider will work with you to select the specialty pharmacy support services that are right for you when starting UPTRAVI®, such as an in-home nurse visit
    • Insurance Verification Insurance verification

      The insurance company may ask your healthcare provider for additional information before they pay for your medicine.

      • A Janssen CarePath Care Coordinator can help with this process by gathering additional information from your healthcare team
    • Delivery of Medicine Delivery of medicine

      UPTRAVI® is shipped to you by a specialty pharmacy.

      • A Janssen CarePath Coordinator will help you connect with a specialty pharmacy that delivers UPTRAVI® in your area
      • Each month, the specialty pharmacy will call you to confirm details of the delivery and arrange your refill
      • You may receive additional services, such as nurse-supported education during your dose adjustment (titration) phase

      Remember, the call from your specialty pharmacy may come from a phone number that you don't know. If you miss the call, it's important that you call back.

    • Refills Refills

      Before your medicine ships each month, your specialty pharmacy will call you to alert you.

Your Janssen CarePath Care Coordinator may need additional information from you at the start of treatment

When you speak with a Care Coordinator, they may ask for additional information, including:

  • Details of your healthcare plan, including the name and contact information for the insurance company and your policy number
  • The name and contact information of your prescribing doctor (including the fax number)
  • Further details from your healthcare team, if your initial claim is denied

If you change insurance plans or healthcare providers, speak with your healthcare team and a Care Coordinator in a timely manner to make sure you can continue your treatment.

Contact a Care Coordinator with questions at , Monday–Friday, 8:00 AM to 8:00 PM ET.

Working With a Specialty Pharmacy

We understand that it is important for you to get your medicine in a timely manner. After you enroll with Janssen CarePath, you will get a call to walk you through the process and discuss medicine delivery. Here are the basic steps you will need to take to fill your UPTRAVI® prescription.

Steps of the specialty pharmacy process

  • Learn about specialty pharmacies.
    Certain medicines, such as UPTRAVI®, aren't kept at your local retail pharmacy. Instead, a specialty pharmacy will ship UPTRAVI® directly to your home.
  • Find the right specialty pharmacy for you.
    Either CVS Specialty or Accredo will call you to discuss financial responsibilities and shipment information.

    You or your healthcare provider may have chosen additional support services such as an in-home nurse visit. Your specialty pharmacy will help you schedule this.

  • Finding the dose that is right for you.
    It can take time for your body to adjust to UPTRAVI®. You may experience side effects as part of the process of finding the dose that is right for you. This is expected and more likely to occur when starting UPTRAVI® or when your healthcare provider changes your dose.

    You can download the Dose Adjustment Phase Guide that highlights important steps and information about titration with UPTRAVI®.

  • Once you find the right dose, continue on your treatment.
    Each month, the specialty pharmacy will call you to confirm details of the delivery and to arrange your refill.

NOTE: The specialty pharmacy may not ship your medicine if they don't speak with you first. Be sure to answer when they call and call them back if they leave a message.

If your health plan does not approve UPTRAVI® treatment

Sometimes you may not be able to obtain the medication that your doctor has ordered for you. For example, your health plan might not cover the medication because it is not on the plan’s drug list (formulary) or the cost is higher than you think you should have to pay. In these situations, you and your doctor have the right to ask the health plan to explain its decision and to consider making the medication available to you as an exception to its policies.