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Summary of resources to help you pay for SIMPONI ARIA® [PDF]

Janssen CarePath Savings Program
- for medication cost support

Eligible patients using commercial or private insurance can save on out-of-pocket medication costs for SIMPONI ARIA®. Depending on your health insurance plan, savings may apply toward co-pay, co-insurance, or deductible. Eligible patients pay $5 for each infusion, with a $20,000 maximum program benefit per calendar year. Not valid for patients using Medicare, Medicaid, or other government-funded programs to pay for their medications. Terms expire at the end of each calendar year and may change. There is no income requirement. Program does not cover the cost to give you your infusion.

We provide cost support directly to patients through the Janssen CarePath 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 you are having any difficulty accessing cost support through the Janssen CarePath Savings Program, please contact us at 877-CarePath (877-227-3728).

See program requirements

To determine if you are eligible for Janssen CarePath Savings Program and get a Savings Program card:

You can also use your online account at MyJanssenCarePath.com to manage your program benefits and submit rebate requests. At your direction, your provider may submit the rebate request and explanation of benefits on your behalf. Please ensure you and your provider coordinate who will submit the rebate request.

To obtain a rebate if you have not created an online account:

  • If you use medical/primary insurance to pay for your medication, you are responsible for submitting a rebate request including an explanation of benefits (EOB) for your treatment from your health insurance provider in order to receive payment from the Savings Program.
  • If you use your pharmacy/prescription insurance to pay for your medication, and the pharmacy is unable to process your card for instant savings, you will need to submit a rebate request.
  • Click here for the rebate form. Complete, sign and return the rebate form (instructions on form), with required proof of purchase, to receive your rebate check paid directly to you. Rebate Form is not required if your rebate is paid directly to your Savings Card or to your Provider (with your assignment of benefit to your provider).

Janssen CarePath Treatment Administration Rebate Program
- for infusion of medication cost support

Eligible patients using commercial or private insurance can save on out-of-pocket treatment administration costs for SIMPONI ARIA®. Eligible patients pay $0 after rebate to patient for administration of each infusion, with a $2,000 maximum program benefit per calendar year. Not valid for patients using Medicare, Medicaid, or other government-funded programs to pay for their treatments. Terms expire at the end of each calendar year and may change. Not valid for residents of MA, MI, MN or RI. There is no income requirement.

See program requirements

To determine if you are eligible for Janssen CarePath Treatment Administration Rebate Program:

You can also use your online account at MyJanssenCarePath.com to manage your program benefits and submit rebate requests.

Before you submit a rebate request, check the Explanation of Benefits (EOB) from your primary health insurance provider, and secondary insurance provider, if applicable, to confirm that you have an out-of-pocket cost responsibility for your treatment administration.

  • If your responsibility is $0, you should not submit a rebate request.
  • If you have out-of-pocket costs for treatment administration, you will need a receipt from your treatment provider indicating you paid. The receipt must include your name, medication, treatment date, and amount you paid for your infusion administration.
  • Submit your rebate request online at MyJanssenCarePath.com or by mail or fax.

Review the Step-by-Step Guide for requesting a rebate on the reverse side of the Rebate Request Form for additional information.

State-Sponsored Programs

Some states sponsor prescription financial assistance programs, each with its own eligibility requirements. Find out if your state has a program that can help you.

Independent co-pay assistance foundations

Independent co-pay assistance foundations have their own rules for eligibility, which are subject to change. We cannot guarantee a foundation will help you. We can only refer you to foundations that support your disease state. This information is provided as a resource for you. We do not endorse any particular foundation. The foundations on this list are not the only ones that might be able to help you.

Additional Affordability Support from Janssen

State-Sponsored Programs

Some states sponsor prescription financial assistance programs, each with its own eligibility requirements. Find out if your state has a program that can help you.

Medicare Savings Program

Many states have programs for people with limited income and resources that pay some or all of Medicare's premiums and may pay Medicare deductibles and co-insurance. Find out if your state has a program that can help you.

Medicaid

Medicaid and the Children's Health Insurance Program (CHIP) provide free or low-cost health coverage to millions of Americans, including some low-income people, families and children, pregnant women, the elderly, and people with disabilities.

Some states have expanded their Medicaid programs to cover all people below certain income levels.

Independent co-pay assistance foundations

Independent co-pay assistance foundations have their own rules for eligibility, which are subject to change. We cannot guarantee a foundation will help you. We can only refer you to foundations that support your disease state. This information is provided as a resource for you. We do not endorse any particular foundation. The foundations on this list are not the only ones that might be able to help you.

Additional Affordability Support from Janssen

State-Sponsored Programs

Some states sponsor prescription financial assistance programs, each with its own eligibility requirements. Find out if your state has a program that can help you.

Medicaid

Medicaid and the Children's Health Insurance Program (CHIP) provide free or low-cost health coverage to millions of Americans, including some low-income people, families and children, pregnant women, the elderly, and people with disabilities.

Some states have expanded their Medicaid programs to cover all people below certain income levels.

Independent co-pay assistance foundations

Independent co-pay assistance foundations have their own rules for eligibility, which are subject to change. We cannot guarantee a foundation will help you. We can only refer you to foundations that support your disease state. This information is provided as a resource for you. We do not endorse any particular foundation. The foundations on this list are not the only ones that might be able to help you.

Johnson & Johnson Patient Assistance Foundation, Inc. (JJPAF)

Janssen CarePath Savings Program
- for medication cost support

Eligible patients using commercial or private insurance can save on out-of-pocket medication costs for SIMPONI ARIA®. Depending on your health insurance plan, savings may apply toward co-pay, co-insurance, or deductible. Eligible patients pay $5 for each infusion, with a $20,000 maximum program benefit per calendar year. Not valid for patients using Medicare, Medicaid, or other government-funded programs to pay for their medications. Terms expire at the end of each calendar year and may change. There is no income requirement. Program does not cover the cost to give you your infusion.

We provide cost support directly to patients through the Janssen CarePath 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 you are having any difficulty accessing cost support through the Janssen CarePath Savings Program, please contact us at 877-CarePath (877-227-3728).

See program requirements

To determine if you are eligible for Janssen CarePath Savings Program and get a Savings Program card:

You can also use your online account at MyJanssenCarePath.com to manage your program benefits and submit rebate requests. At your direction, your provider may submit the rebate request and explanation of benefits on your behalf. Please ensure you and your provider coordinate who will submit the rebate request.

To obtain a rebate if you have not created an online account:

  • If you use medical/primary insurance to pay for your medication, you are responsible for submitting a rebate request including an explanation of benefits (EOB) for your treatment from your health insurance provider in order to receive payment from the Savings Program.
  • If you use your pharmacy/prescription insurance to pay for your medication, and the pharmacy is unable to process your card for instant savings, you will need to submit a rebate request.
  • Click here for the rebate form. Complete, sign and return the rebate form (instructions on form), with required proof of purchase, to receive your rebate check paid directly to you. Rebate Form is not required if your rebate is paid directly to your Savings Card or to your Provider (with your assignment of benefit to your provider).

Janssen CarePath Treatment Administration Rebate Program
- for infusion of medication cost support

Eligible patients using commercial or private insurance can save on out-of-pocket treatment administration costs for SIMPONI ARIA®. Eligible patients pay $0 after rebate to patient for administration of each infusion, with a $2,000 maximum program benefit per calendar year. Not valid for patients using Medicare, Medicaid, or other government-funded programs to pay for their treatments. Terms expire at the end of each calendar year and may change. Not valid for residents of MA, MI, MN or RI. There is no income requirement.

See program requirements

To determine if you are eligible for Janssen CarePath Treatment Administration Rebate Program:

You can also use your online account at MyJanssenCarePath.com to manage your program benefits and submit rebate requests.

Before you submit a rebate request, check the Explanation of Benefits (EOB) from your primary health insurance provider, and secondary insurance provider, if applicable, to confirm that you have an out-of-pocket cost responsibility for your treatment administration.

  • If your responsibility is $0, you should not submit a rebate request.
  • If you have out-of-pocket costs for treatment administration, you will need a receipt from your treatment provider indicating you paid. The receipt must include your name, medication, treatment date, and amount you paid for your infusion administration.
  • Submit your rebate request online at MyJanssenCarePath.com or by mail or fax.

Review the Step-by-Step Guide for requesting a rebate on the reverse side of the Rebate Request Form for additional information.

State-Sponsored Programs

Some states sponsor prescription financial assistance programs, each with its own eligibility requirements. Find out if your state has a program that can help you.

Medicare Savings Program

Many states have programs for people with limited income and resources that pay some or all of Medicare's premiums and may pay Medicare deductibles and co-insurance. Find out if your state has a program that can help you.

Medicaid

Medicaid and the Children's Health Insurance Program (CHIP) provide free or low-cost health coverage to millions of Americans, including some low-income people, families and children, pregnant women, the elderly, and people with disabilities.

Some states have expanded their Medicaid programs to cover all people below certain income levels.

Independent co-pay assistance foundations

Independent co-pay assistance foundations have their own rules for eligibility, which are subject to change. We cannot guarantee a foundation will help you. We can only refer you to foundations that support your disease state. This information is provided as a resource for you. We do not endorse any particular foundation. The foundations on this list are not the only ones that might be able to help you.

Additional Affordability Support from Janssen

Johnson & Johnson Patient Assistance Foundation, Inc. (JJPAF)

IMPORTANT SAFETY INFORMATION

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WHAT IS SIMPONI ARIA® (golimumab)?

SIMPONI ARIA® is a prescription medicine used to treat:

  • Moderate to severe rheumatoid arthritis (RA) in adults, used in combination with methotrexate
  • Active psoriatic arthritis (PsA) in people 2 years of age and older
  • Active ankylosing spondylitis (AS) in adults
  • Active polyarticular juvenile idiopathic arthritis (pJIA) in people 2 years of age and older

IMPORTANT SAFETY INFORMATION

SERIOUS INFECTIONS

SIMPONI ARIA® (golimumab) is a prescription medicine. SIMPONI ARIA® can lower your ability to fight infections. There are reports of serious infections caused by bacteria, fungi, or viruses that have spread throughout the body, including tuberculosis (TB) and histoplasmosis. Some of these infections have been fatal. Your doctor will test you for TB before starting SIMPONI ARIA® and will closely monitor you for signs of TB during treatment. Tell your doctor if you have been in close contact with people with TB. Tell your doctor if you have been in a region (such as the Ohio and Mississippi River Valleys and the Southwest) where certain fungal infections like histoplasmosis or coccidioidomycosis are common.

You should not receive SIMPONI ARIA® if you have any kind of infection. Tell your doctor if you are prone to or have a history of infections or have diabetes, HIV or a weak immune system. You should also tell your doctor if you are currently being treated for an infection or if you have or develop any signs of an infection such as:

  • fever, sweat, or chills
  • muscle aches
  • cough
  • shortness of breath
  • blood in phlegm
  • weight loss
  • warm, red, or painful skin or sores on your body
  • diarrhea or stomach pain
  • burning when you urinate or urinate more than normal
  • feel very tired

Your doctor will examine you for TB and perform a test to see if you have TB. If your doctor feels that you are at risk for TB, you may be treated with medicine for TB before you begin treatment with SIMPONI ARIA® and during treatment with SIMPONI ARIA®. Even if your TB test is negative, your doctor should carefully monitor you for TB infections while you are taking SIMPONI ARIA®. People who had a negative TB skin test before receiving SIMPONI ARIA® have developed active TB. Tell your doctor if you have any of the following symptoms while taking or after taking SIMPONI ARIA®:

  • cough that does not go away
  • low grade fever
  • weight loss
  • loss of body fat and muscle (wasting)

CANCER

Unusual cancers have been reported in children and teenage patients taking Tumor Necrosis Factor (TNF)-blocker medicines. For children and adults receiving TNF blockers, including SIMPONI ARIA®, the chances for getting lymphoma or other cancers may increase. Hepatosplenic T-cell lymphoma, a rare and fatal lymphoma, has occurred mostly in teenage or young adult males with Crohn’s disease or ulcerative colitis who were taking a TNF blocker with azathioprine or 6-mercaptopurine. You should tell your doctor if you have had or develop lymphoma or other cancers.

Some people treated with SIMPONI ARIA® developed skin cancer. Tell your doctor if any changes in the appearance of your skin or growths on your skin occur during or after your treatment with SIMPONI ARIA®. Your doctor should periodically examine your skin, especially if you have a history of skin cancer.

USE WITH OTHER DRUGS

Tell your doctor about all the medications you take including ORENCIA® (abatacept), KINERET® (anakinra), ACTEMRA® (tocilizumab), RITUXAN® (rituximab), or another TNF blocker, or if you are scheduled to or recently received a vaccine. People receiving SIMPONI ARIA® should not receive live vaccines or treatment with a weakened bacteria (such as BCG for bladder cancer).

HEPATITIS B INFECTION

Reactivation of hepatitis B virus has been reported in patients who are carriers of this virus and are receiving TNF-blocker medicines, such as SIMPONI ARIA®. Some of these cases have been fatal. Your doctor should do blood tests before and after you start treatment with SIMPONI ARIA®. Tell your doctor if you know or think you may be a carrier of hepatitis B virus or if you experience signs of hepatitis B infection, such as:

  • feel very tired
  • dark urine
  • skin or eyes look yellow
  • little or no appetite
  • vomiting
  • muscle aches
  • clay-colored bowel movements
  • fever
  • chills
  • stomach discomfort
  • skin rash

HEART FAILURE

Heart failure can occur or get worse in people who use TNF blockers, including SIMPONI ARIA®. If you develop new or worsening heart failure with SIMPONI ARIA®, you may need treatment in a hospital, and it may result in death. Your doctor will closely monitor you if you have heart failure. Tell your doctor right away if you get new or worsening symptoms of heart failure like shortness of breath, swelling of your lower legs or feet, or sudden weight gain.

NERVOUS SYSTEM PROBLEMS

Rarely, people using TNF blockers, including SIMPONI ARIA®, can have nervous system problems such as multiple sclerosis or Guillain-Barré syndrome. Tell your doctor right away if you have symptoms like vision changes, weakness in your arms or legs, or numbness or tingling in any part of your body.

IMMUNE SYSTEM PROBLEMS

Rarely, people using TNF blockers have developed lupus-like symptoms. Tell your doctor if you have any symptoms such as a rash on your cheeks or other parts of the body, sensitivity to the sun, new joint or muscle pain, becoming very tired, chest pain or shortness of breath, or swelling of the feet, ankles or legs.

LIVER PROBLEMS

Serious liver problems can happen in people using TNF blockers, including SIMPONI ARIA®. Contact your doctor immediately if you develop symptoms such as feeling very tired, skin or eyes look yellow, poor appetite or vomiting, or pain on the right side of your stomach.

BLOOD PROBLEMS

Low blood counts have been seen with people using TNF blockers, including SIMPONI ARIA®. If this occurs, your body may not make enough blood cells to help fight infections or help stop bleeding. Your doctor will check your blood counts before and during treatment. Tell your doctor if you have signs such as fever, bruising, bleeding easily, or paleness.

ALLERGIC REACTIONS

Allergic reactions can happen in people who use TNF-blocker medicines, including SIMPONI ARIA®. Tell your doctor if you have any symptoms of an allergic reaction while receiving SIMPONI ARIA® such as hives, swollen face, breathing trouble, or chest pain. Some reactions can be serious and life-threatening.

OTHER CONSIDERATIONS TO TELL YOUR DOCTOR

Tell your doctor if you have psoriasis.

Tell your doctor if you are pregnant, planning to become pregnant, are breastfeeding, or plan to breastfeed, or have a baby and received SIMPONI ARIA® during pregnancy. Tell your baby’s doctor before your baby receives any vaccine because of an increased risk of infection for up to 6 months after birth.

COMMON SIDE EFFECTS

The most common side effects of SIMPONI ARIA® include: upper respiratory infection, abnormal liver tests, decreased blood cells that fight infection, viral infections, bronchitis, high blood pressure, and rash.

Please read the full Prescribing Information and Medication Guide for SIMPONI ARIA® and discuss any questions you have with your doctor.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

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