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This program provides brand name medications at no or low cost.
Pharmaceutical Company	Johnson & Johnson Patient Assistance Foundation, Inc
Program Name	Johnson & Johnson Hospital Access Patient Assistance Program
Program Address	PO Box 220455 Charlotte, NC 28222-0455
Phone Number	800-652-6227
Fax Number	800-521-2437
Medications on Program	Ditropan XL Tablets (oxybutynin chloride)
Application Forms	Hospital Access Patient Assistance Program
On-line Application	No on-line application available at this time
Web Site	Click to go to program's web site
Eligibility Guidelines and Notes	The patient can have no public or private prescription insurance and and have an income at or below 200% of the Federal Poverty Level, adjusted for family size. Medical diagnosis necessary for this program is not specified. The patient must also be a US resident with a prescription from a US doctor. For Doxil and Procrit, income may be up to 400% FPL. Patients receiving Procrit for dialysis are not eligible for this program. This program is intended to provide qualified outpatients access to medications through a qualified DSH or DRG-exempt Cancer Center. DSH facilities and DRG-exempt Cancer Centers are assessed for eligibility according to standardized criteria.
Application Process	Someone from the hospital must call for an application.
Application Requirements	Someone from the hospital must fill out a product request form for each replacement.
Program Details	The amount requested is sent to the hospital.
Last Updated	June 08, 2010

Program 2 of 2.

This program provides brand name medications at no or low cost.
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	800-523-5870
Fax Number	888-526-5168
Medications on Program	Ditropan XL Tablets 5mg, 10mg, 15mg (oxybutynin)
Application Forms	Johnson & Johnson Patient Assistance Program
On-line Application	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.
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 the health care professional are notified in writing of acceptance or denial.
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.
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.
Last Updated	June 09, 2010