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Johnson & Johnson Patient Assistance Foundation, Inc. Patient Assistance Program
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PO Box 221857
Charlotte, NC 28222
Phone
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(800)652-6227
Fax:
(888)526-5168
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Eligibility
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The Johnson & Johnson Patient Assistance Foundation, Inc. Patient Assistance Program provides brand name medications at no or low cost. Patients must have prescription coverage the needed medication. Some Medicare Part D patients who cannot afford their medicines, and who meet certain financial criteria, may also be eligible for assistance. Patient must permanently reside in the US or a US territory. |
| Who Can Apply
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Applications can be obtained by patients and doctors by calling or downloading from the link below. |
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Required
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Applications must be completed and signed by both the patient and doctor. Proof on income must also be attached. New application and documentation is needed every year. |
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Supply
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Not specified. Refill process varies by medication. |
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Ship To
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Doctor's office or a card will be sent to the patient to used at the pharmacy. |
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Note
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Includes Support for This Drug
NOTE: Linked drugs are available for Prescribers to Apply Online now.
Click drug logo or drug name to start online application.
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| Concerta XR Tablets |
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Printable Application Forms
Applications that patients can fill out and bring to their doctor.
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| Download printable Form |
(Requires Acrobat Reader) 
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McNeil Consumer and Specialty Pharmaceuticals PAP
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McNeil Consumer and Specialty Pharmaceuticals PAP
PO Box 1015
San Bruno, CA 94066
Phone
:
(866) 727-4626
Fax:
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Eligibility
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Eligibility is based on income and lack of third party prescription coverage. |
| Who Can Apply
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Physician's office must apply on patient's behalf. |
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Required
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A completed application with the physician's original signature and patient's income documentation are required. |
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Supply
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Flexeril is provided in a 90 day supply. For patients on Concerta, a six month supply of coupons is provided, each good for a thirty day prescription. |
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Ship To
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Physician's office or patient's home. |
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Note
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Physician must certify medical need. Income and insurance (indicating no prescription coverage) documentation must accompany application. |
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Includes Support for This Drug
NOTE: Linked drugs are available for Prescribers to Apply Online now.
Click drug logo or drug name to start online application.
|
| Concerta XR Tablets |
| |
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
|
| Download printable Form Application Form |
| Download printable Form Application Form |
| (Requires Acrobat Reader)
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