Am I eligible for the program?

You may be eligible for our free prescription program if you meet the requirements below:

You have been prescribed a Johnson & Johnson operating company donated medication
You meet the eligibility income requirements for the medication(s). You may view the income requirements below
You don’t have insurance or medicine is not covered
- Some patients with Medicare Prescription Drug Coverage (Part D) who cannot afford their medicines and who meet certain financial criteria may also be eligible for assistance
  - A report from your pharmacy or an Explanation of Benefits (EOB) statement from your insurer that shows your out-of-pocket costs for the current year can be requested and may be submitted with your application. In order to qualify for the program, you must spend 4% or more of your gross annual income on prescription drugs.
You live in the United States or a U.S. Territory
You are being treated by a U.S. licensed doctor as an outpatient

Medication

CONCERTA^{® †}
(methylphenidate HCI) Extended-Release Tablets CII

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

DARZALEX^®
(daratumumab) Injection for intravenous infusion

$49,960 $67,640 $85,320 $103,000 $120,680 Variable – please call us for more information

DOXIL^{® †}
(doxorubicin HCL liposome) IV Infusion

$49,960 $67,640 $85,320 $103,000 $120,680 Variable – please call us for more information

EDURANT^{® 1}
(rilpivirine) Tablets

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

ELMIRON^®
(pentosan polysulfate sodium) Capsules

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

ERLEADA^®
(apalutamide) Tablets

$49,960 $67,640 $85,320 $103,000 $120,680 Variable – please call us for more information

HALDOL^{® †}
(haloperidol) Immediate-Release Injection

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

HALDOL^® Decanoate^†
(haloperidol) IM Injection Only

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

IMBRUVICA^®
(ibrutinib) Capsules/Tablets

$74,940 $101,460 $127,980 $154,500 $181,020 Variable – please call us for more information

INTELENCE^{® 1}
(etravirine) Tablets

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

INVEGA SUSTENNA^{® †}
(paliperidone palmitate) Extended-Release Injectable Suspension

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

INVEGA TRINZA^®^†
(paliperidone palmitate) Extended-Release Injectable Suspension

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

INVOKAMET^®^{† 1}
(canagliflozin/metformin HCI) Tablets

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

INVOKAMET^® XR^{† 1}
(canagliflozin/metformin HCI) Tablets

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

INVOKANA^®^{† 1}
(canagliflozin) Tablets

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

MONOVISC^®
(high molecular weight hyaluronan) Injection

$49,960 $67,640 $85,320 $103,000 $120,680 Variable – please call us for more information

ORTHOVISC^®
(high molecular weight hyaluronan) Injection

$49,960 $67,640 $85,320 $103,000 $120,680 Variable – please call us for more information

PANCREAZE^®
(pancrelipase) Delayed-Release Capsules

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

PREZCOBIX^®¹
(darunavir 800mg/cobicistat 150mg) Tablets

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

PREZISTA^{® 1}
(darunavir) Tablets/Oral Suspension

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

PROCRIT^{® †}
(epoetin alfa) Injection

$49,960 $67,640 $85,320 $103,000 $120,680 Variable – please call us for more information

REMICADE^{® †}
(infliximab) IV Infusion

$49,960 $67,640 $85,320 $103,000 $120,680 Variable – please call us for more information

RISPERDAL CONSTA^{® †}
(risperidone) Long-Acting Injection

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

SIMPONI^{® †}
(golimumab) Injection

$49,960 $67,640 $85,320 $103,000 $120,680 Variable – please call us for more information

SIMPONI ARIA^®^†
(golimumab) IV Infusion

$49,960 $67,640 $85,320 $103,000 $120,680 Variable – please call us for more information

SIRTURO^®
(bedaquiline) Tablets

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

SPORANOX^{® †}
(itraconazole) Capsules

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

SPORANOX^{® †}
(itraconazole) Oral Solution

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

SPRAVATO^{™ †}
(esketamine) Nasal Spray, for intranasal use, CIII

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

STELARA^®
(ustekinumab) Injection, for subcutaneous or intravenous use

$49,960 $67,640 $85,320 $103,000 $120,680 Variable – please call us for more information

SYMTUZA^®
(darunavir, cobicistat, emtricitabine, and tenofovir alafenamide) Tablets

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

TREMFYA^®
(guselkumab) Injection, for subcutaneous use

$49,960 $67,640 $85,320 $103,000 $120,680 Variable – please call us for more information

XARELTO^{® † 1}
(rivaroxaban) Tablets

$37,470 $50,730 $63,990 $77,250 $90,510 Variable – please call us for more information

YONDELIS^®
(trabectedin) Injection for intravenous infusion

$49,960 $67,640 $85,320 $103,000 $120,680 Variable – please call us for more information

ZYTIGA^®
(abiraterone acetate) Tablets

$49,960 $67,640 $85,320 $103,000 $120,680 Variable – please call us for more information

† Please see full U.S. prescribing information, including Black Box warning for: CONCERTA^®, DOXIL^®, HALDOL^®, HALDOL^® DECANOATE, INVEGA SUSTENNA^®, INVEGA TRINZA^®, INVOKAMET^®, INVOKAMET^® XR, INVOKANA^®, PROCRIT^®, REMICADE^®, RISPERDAL CONSTA^®, SIMPONI^®, SIMPONI ARIA^®, SPORANOX^®, SPORANOX^® ORAL SOLUTION, XARELTO^®

1 These products are also available for hospital outpatients in our Hospital Access Patient Assistance Program