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
Select Family Size

BALVERSA™
(erdafitinib) Tablets

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

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