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This program provides brand name medications at no or low cost.
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| Pharmaceutical Company |
Johnson & Johnson Patient Assistance Foundation, Inc |
| Program Name |
Johnson & Johnson Patient Assistance Program |
| Program Address |
PO Box 221857
Charlotte, NC 28222-1857 |
| Phone Number |
800-652-6227, opt 1
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| Fax Number |
888-526-5168 |
| Medications on Program |
Aciphex tablets (rabeprazole sodium)
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| Application Forms |
Johnson & Johnson Patient Assistance Program
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On-line Application
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No on-line application available at this time |
| Web Site |
Click to go to program's web site |
| Eligibility Guidelines and Notes |
The patient must have no prescription coverage for the requested medication and meet income guidelines that are not disclosed. Medical diagnosis necessary for this program is not specified. The patient must also be a US resident. This programs helps qualified patients gain access to medications donated by the operating companies of Johnson & Johnson. Medicare LIS (Low Income Subsidy) eligible patients are not eligible to receive assistance through this program. Patients receiving benefits under a Medicare Part D prescription drug plan are not eligible to receive assistance through this program, however program eligibility exceptions for Medicare Part D enrollees based on significant financial or medical need will be considered.
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| Application Process |
With the patient's permission, anyone concerned can call for an application. The application will be faxed out. The completed application can be faxed or mailed back.
Both the patient and doctor are notified in writing of acceptance or denial.
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| Application Requirements |
The doctor must fill out a section and sign the application. The patient must fill out a section, sign the application and attach proof of income.
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| Program Details |
The medications are either sent to the doctor's office or the patient is sent a pharmacy card. The company automatically sends out refills. Once a year a new application with financial documentation is needed.
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| Last Updated |
November 13, 2009 |
