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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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| Axert Tablets |
| Concerta XR Tablets |
| Darzalex |
| Doxil Injection |
| Duragesic CII Patch |
| Edurant tablet |
| Elmiron Capsules |
| Haldol Decanoate Injection |
| Haldol Injection |
| Imbruvica capsule |
| Intelence Tablet |
| Invega Extended Release Tablets |
| Invega Sustenna injection; extended release |
| Invega Trinza injection for suspension; extended release |
| Invokamet tablet |
| Invokana tablet |
| Levaquin Oral Solution |
| Levaquin Tablets |
| Monovisc injection |
| Olysio capsule |
| OrthoVisc Solution |
| Pancrease Capsules |
| Prezcobix tablet |
| Prezista Tablets |
| Procrit Solution |
| Razadyne ER Capsules |
| Razadyne Tablets |
| Razadyne Oral Solution |
| Remicade (infliximab) |
| Risperdal Consta Long Acting Injection |
| Risperdal M-TAB Tablets |
| Risperdal Oral Solution |
| Risperdal Tablets |
| Simponi |
| Simponi Aria |
| Sporanox Capsules |
| Stelara injection |
| Sylvant |
| Topamax Sprinkle Capsules (topiramate) |
| Topamax Tablets |
| Xarelto tablet |
| Yondelis |
| Zytiga tablet |
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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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