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otsuka patient assistance application pdf

by Dr. Isai Crona MD Published 2 years ago Updated 1 year ago
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How do I apply for Otsuka Patient Assistance Foundation?

If you qualify, please contact your HCP, who must apply on your behalf. Learn more about the application process. If you’re an HCP, you can use the Otsuka Patient Assistance Foundation (OPAF) portal on behalf of your patients to submit and track applications, download forms, access patient information, and more.

Which Otsuka medications are eligible for insurance assistance?

Eligible patients prescribed Otsuka medications ABILIFY® (aripiprazole) Tablets, ABILIFY MAINTENA® (aripiprazole), JYNARQUE® (tolvaptan), REXULTI® (brexpiprazole), or SAMSCA® (tolvaptan) may be eligible for other coverage assistance and additional patient support offerings.

What is Otsuka patient education network?

Patients are more than just their diagnoses. That’s why we started the Otsuka Patient Education Network (OPEN), which develops and nurtures projects that give patients, their families, and their caregivers educational resources about diseases they may face.

How do I apply for OPAF assistance?

For assistance, please contact a Dedicated Patient Case Coordinator at 1-855-727-6274. If your patient qualifies for assistance from OPAF, the next step is for you to submit an application on their behalf. ABILIFY MAINTENA, JYNARQUE, REXULTI, and SAMSCA® (tolvaptan) tablets.

How to contact OPAF about a hardship?

What time does Otsuka open?

How long does it take to activate OPAF?

What is the phone number for OPAF?

Why is secure messaging important?

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What is Otsuka Patient Assistance Foundation?

The Otsuka Patient Assistance Foundation, Inc. (OPAF) is a nonprofit organization that provides eligible patients with prescribed Otsuka medication free of cost. For assistance, please contact a Dedicated Patient Case Coordinator at 1-855-727-6274.

Does Abilify have a patient assistance program?

The Simplefill program is designed to help patients facing chronic conditions pay for their costly medications. To find out how to get help paying for Abilify, learn more about our patient assistance programs and apply today.

Does Rexulti have a patient assistance program?

At Simplefill, we help Americans who are struggling to pay for the medications they take to manage chronic diseases such as schizophrenia. Learn more about Rexulti patient assistance programs, and enroll with Simplefill today.

How much is Abilify at Walgreens?

Cost Comparison of Generic and Brand-Name AripiprazolePharmacyBrand Name Abilify Cost for 5mg, 30 tabletsGeneric Aripiprazole Cost for 5mg, 30 tabletsWalgreens$610.23$244.28Wegmans$581.46$14.14Duane Reade$610.23$244.28Target$606.23$199.884 more rows•Aug 23, 2022

Does Abilify cause weight gain?

Abilify (aripiprazole) is an atypical antipsychotic that can cause weight gain. But the chance of weight gain seems to be less than that of other atypical antipsychotics. You can help prevent weight gain from Abilify by making healthy lifestyle choices, such as exercising regularly and eating a healthy diet.

How much does the Rexulti savings card cover?

Manufacturer CouponProgram Name:Rexulti Savings CardWebsite:https://www.rexulti.com/us/mdd/savings/How do I get the discount?Register online to download and print a card.How much can I save?You can receive your first two months free, then pay as little as $15 copay on each refill with a maximum monthly savings of $600.6 more rows•Dec 21, 2018

How much does Rexulti cost per month?

While your cost for REXULTI will depend on your specific plan, the average cost is $30.60 per month. 89% of patients using the REXULTI Savings Card pay $15 or less per month.

When will there be a generic for Rexulti?

Rexulti was eligible for patent challenges on July 10, 2019. By analyzing the patents and regulatory protections it appears that the earliest date for generic entry will be October 12, 2032.

Is Abilify expensive?

About Abilify Aripiprazole (Abilify) is an inexpensive drug used to treat schizophrenia and bipolar disorder, also known as manic-depression. It is also used to treat Tourette's disorder and some symptoms of autism. This medicine may also be used in combination with antidepressants to treat major depressive disorder.

What is the generic name for Abilify?

Generic Name: aripiprazole Aripiprazole is used to treat certain mental/mood disorders (such as bipolar disorder, schizophrenia, Tourette's syndrome, and irritability associated with autistic disorder). It may also be used in combination with other medication to treat depression.

How do I get Abilify?

These can be retail pharmacies, urgent care clinics, dialysis centers, and infusion centers where a healthcare provider can give you your ABILIFY MAINTENA. To learn more about LCCs, visit OtsukaPatientSupport.com or call 1-855-242-7787.

What is Aripiprazole generic for?

Abilify is an atypical antipsychotic medication used to treat mental health conditions like schizophrenia and bipolar disorder. The generic version, aripiprazole, was approved by the FDA in 2015 and offers a less expensive choice that works just as well. Abilify comes in several dosage forms.

Patient Assistance Program Enrollment Form for REXULTI ... - RxHope

Confidential - Protected Health Information May 2015 11US15EBA0023 The patient, or the patient’s authorized representative, MUST sign this form to receive product at no cost from the Otsuka Patient Assistance

Patient Enrollment Form - ARISTADA Care Support

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Otsuka Patient Support

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ABILIFY Patient Assistance Program

There are over 100 million Americans that either can‚t afford their medication or are struggling to afford their medication. We aim to help each and every American in that situation.

Mobile Injection Form

Please see FULL PRESCRIBING INFORMATION, including BOXED WARNING. Mobile Injection Form PATIENT PRESCRIPTION DELIVERY Please fill out applicable fields OR indicate that the information is attached.

NeedyMeds

NeedyMeds has free information on medication and healthcare costs savings programs including prescription assistance programs and medical and dental clinics.

Have Questions About OPAF and Don't Have Time for a Phone Call?

Send a secure message directly to a Dedicated OPAF Patient Case Coordinator.

How to contact OPAF about a hardship?

If you are facing a hardship because of the COVID-19 crisis such as: Changes to your employment status such as losing your job or being temporarily furloughed; Changes in your insurance or medication costs; Please contact OPAF immediately at 1-855-727-6274 to discuss potential assistance.

What time does Otsuka open?

Our foundation is open during our standard business hours of Monday-Friday 8am-8pm EDT.

How to get an OPAF online?

If you'd prefer, you can download the application and email it to your HCP or bring it to your next appointment.

What happens if you are not accepted for OPAF?

If you aren’t accepted for OPAF assistance, please check your eligibility again when your income or insurance coverage changes.

How to contact OPAF about a hardship?

If you are facing a hardship because of the COVID-19 crisis such as: Changes to your employment status such as losing your job or being temporarily furloughed; Changes in your insurance or medication costs; Please contact OPAF immediately at 1-855-727-6274 to discuss potential assistance.

How long does it take to get an answer from OPAF?

If your healthcare professional [HCP] submits an application online via the OPAF Care Connect Prescriber Portal, they will receive an answer within 48 hours upon receipt of the submitted application and all required supporting documentation.

Where to apply for HCP?

Having your healthcare professional [HCP] apply online at the OPAF Care Connect Prescriber Portal is the fastest way to get an official decision from OPAF.

What time does Otsuka open?

Our foundation is open during our standard business hours of Monday-Friday 8am-8pm EDT.

How to check if you qualify for Jynarque?

To check eligibility for JYNARQUE, please call 1-855-727-6274. You may not be eligible for assistance. Before assistance can be considered, a valid prescription is required. This interactive tool is just your first step in determining eligibility for medication from Otsuka provided at no cost.

What does it mean when you use a prescription card?

When you use this card, you are certifying that you have not submitted and will not submit a claim for reimbursement under any federal, state, or other governmental programs for this prescription. As a condition of payment, you certify that you are in compliance with all program rules, terms, and conditions, as well as with any obligations to provide notice of your participation in this program to third-party payers as required by law, contract, or otherwise.

What is Otsuka patient support?

That’s why we created Otsuka Patient Support. It combines resources and tools for patients, their care partners, and their prescribing team, with access to dedicated support from our team. Our commitment to you isn’t just our promise, it’s also our passion.

What is the number to call for a pharmacist?

Patients with questions about the offer should call 1-888-591-9812. Pharmacist:

What is Otsuka Patient Assistance Foundation?

The Otsuka Patient Assistance Foundation, Inc (OPAF), is a nonprofit organization that assists underinsured and uninsured patients who have been prescribed Otsuka medications. OPAF has specific eligibility criteria that applicants must meet prior to their approval for assistance.

What is Otsuka Patient Education Network?

That’s why we started the Otsuka Patient Education Network (OPEN), which develops and nurtures projects that give patients, their families, and their caregivers educational resources about diseases they may face.

What is the phone number for Otsuka?

Visit the website to learn more, or for more information about assistance with a specific medication, call OPAF at: 855-727-6274, Monday through Friday, 8 AM to 8 PM eastern time. Visit site.

How to contact OPAF about a hardship?

If you are facing a hardship because of the COVID-19 crisis such as: Changes to your employment status such as losing your job or being temporarily furloughed; Changes in your insurance or medication costs; Please contact OPAF immediately at 1-855-727-6274 to discuss potential assistance.

What time does Otsuka open?

Our foundation is open during our standard business hours of Monday-Friday 8am-8pm EDT.

How long does it take to activate OPAF?

The activation process takes less than 3 minutes. Once your account is active, you can send messages to OPAF immediately. To setup your OPAF secure message account follow the steps below: Click on the (button or envelope) below to start the process.

What is the phone number for OPAF?

If you have any questions, please contact OPAF at 1-855-727-6274 8:00 AM - 8:00 PM EST.

Why is secure messaging important?

Secure messaging ensures patient privacy because it is a HIPAA-compliant, password-protected electronic messaging platform. You can communicate directly with an OPAF Patient Case Coordinator without having to pick up the phone. Through the platform you can securely send electronic messages with any questions, communications, and documents at your convenience.

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