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remicade patient assistance program product request form

by Lexus Reichert Published 1 year ago Updated 1 year ago

How can I get help paying for Remicade®?

Janssen CarePath Savings Program can help eligible patients save on their out-of-pocket medication costs for REMICADE®. Your eligible patients will pay $5 per infusion with a $20,000 maximum program benefit per calendar year. Not valid for patients using Medicare, Medicaid, or other government-funded programs to pay for their medications.

What is the patient authorization form for Remicade®?

This combined BI and prescription form for REMICADE® includes a Patient Authorization Form, which is required on a per-patient basis for practices that do not have an executed Business Associate Agreement (BAA) and can be used across REMICADE® indications.

What is Remicade used to treat?

REMICADE® is indicated for reducing signs and symptoms in adult patients with active ankylosing spondylitis (AS). REMICADE® is indicated for reducing signs and symptoms of active arthritis, inhibiting the progression of structural damage, and improving physical function in adult patients with psoriatic arthritis (PsA).

How do I sign up for Remicade® through Janssen?

Sign up or log in to your personal Janssen CarePath account at MyJanssenCarePath.com so you can learn about your insurance coverage for REMICADE®; if eligible, enroll in the Janssen CarePath Savings Program and manage program benefits; and sign up for treatment support.

What is the phone number for Janssen Carepath?

If you have any questions, please call a Janssen CarePath Care Coordinator at 877-CarePath (877-227-3728) , Monday-Friday 8:00 AM to 8:00 PM ET. Multilingual phone support is available. Visit JanssenCarePath.com/REMICADE.

Can you get IV infusions on-site?

Some doctors offer IV infusion services on-site. If your doctor’s office doesn’t, it’s easy to find an infusion center near you.

Does Janssen CarePath cover out-of-pocket costs?

Janssen CarePath can explain your potential out-of-pocket costs and identify cost-support options that may help with managing your out-of-pocket costs—whether you have commercial or private health insurance, government-funded healthcare coverage such as Medicare or Medicaid, or have no insurance coverage:

What is the name of the medicine that is used to treat a remicade?

Use the medicines Kineret (anakinra), Orencia (abatacept) or Actemra (tocilizumab) or other medicines called biologics used to treat the same problems as REMICADE ® .

How long after birth can a baby get a remicde?

Tell your baby’s doctor about your REMICADE ® use. If your baby receives a live vaccine within 6 months after birth, your baby may develop infections with serious complications that can lead to death. Recently received or are scheduled to receive a vaccine.

How to report side effects of prescription drugs?

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Can you take Infliximab for TB?

Only your doctor can recommend a course of treatment after checking your health condition. REMICADE ® (infliximab) can cause serious side effects such as lowering your ability to fight infections. Some patients, especially those 65 years and older, have had serious infections which include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body or caused infections in certain areas (such as skin). Some of these infections have been fatal. Your doctor should monitor you closely for signs and symptoms of TB during treatment with REMICADE®.

What is the name of the medicine that is used to treat a remicade?

Use the medicines Kineret (anakinra), Orencia (abatacept) or Actemra (tocilizumab) or other medicines called biologics used to treat the same problems as REMICADE ® .

How long after birth can a baby get a remicde?

Tell your baby’s doctor about your REMICADE ® use. If your baby receives a live vaccine within 6 months after birth, your baby may develop infections with serious complications that can lead to death. Recently received or are scheduled to receive a vaccine.

How to report side effects of prescription drugs?

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Does remicde cause a sore throat?

Psoriasis —new or worsening psoriasis such as red scaly patches or raised bumps on the skin that are filled with pus. The more common side effects of REMICADE® include respiratory infections (such as sinus infections and sore throat), headache, coughing and stomach pain.

Can you get TB before remicde?

Tuberculosis (TB) or have been near someone who has TB. Your doctor will check you for TB with a skin test. If you have latent (inactive) TB, you will begin TB treatment before you start REMICADE ® . Lived in a region where certain fungal infections like histoplasmosis, coccidioidomycosis, or blastomycosis are common.

Can you take Infliximab for TB?

Only your doctor can recommend a course of treatment after checking your health condition. REMICADE ® (infliximab) can cause serious side effects such as lowering your ability to fight infections. Some patients, especially those 65 years and older, have had serious infections which include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body or caused infections in certain areas (such as skin). Some of these infections have been fatal. Your doctor should monitor you closely for signs and symptoms of TB during treatment with REMICADE®.

Can remicade cause fever?

Serious infections (like TB, blood infections, pneumonia) —fever, tiredness, cough, flu-like symptoms, or warm, red or painful skin or any open sores. REMICADE ® can make you more likely to get an infection or make any infection that you have worse.

What is the Medicare Part D Extra Help number?

Medicare Part D Extra Help—Low-Income Subsidy. Independent Foundations*. Call a Janssen CarePath Care Coordinator at 877-CarePath (877-227-3728) or visit JanssenPrescriptionAssistance.com for more information on affordability programs that may be available.

How to find an infusion center?

Utilize the search capabilities of 2infuse.com to help you locate an infusion center convenient to your patient’s home or office. Searchable by city or ZIP code, this helpful site provides detailed search results organized by driving distance. This website also includes valuable information about the infusion center such as business hours, insurance plans accepted, and medications infused.

How to contact Janssen Carepath?

Call a Janssen CarePath Care Coordinator at 877-CarePath (877-227-3728) , Monday-Friday, 8:00 AM to 8:00 PM ET. Multilingual phone support available. Sign Up or Log In to the Provider Portal at JanssenCarePathPortal.com. Visit JanssenCarePath.com.

Is Infliximab biosimilar to Remicade?

Please note that no infliximab biosimilar has been designated as interchangeable with REMICADE®. 1-4

What are the most common adverse reactions to remicade?

In clinical trials, the most common adverse reactions occurring in >10% of REMICADE®-treated patients included infections (eg, upper respiratory, sinusitis, and pharyngitis), infusion-related reactions, headache, and abdominal pain.

Is remicde used for tuberculosis?

Active tuberculosis (TB), including reactivation of latent TB. Patients frequently presented with disseminated or extrapulmonary disease. Patients should be tested for latent TB before and during treatment with REMICADE®. 1,2 Treatment for latent infection should be initiated prior to treatment with REMICADE®.

Does Remicade cause hypersensitivity?

REMICADE® has been associated with hypersensitivity reactions that differ in their time of onset. Anaphylaxis, acute urticaria, dyspnea, and hypotension have occurred in association with infusions of REMICADE®. Medications for the treatment of hypersensitivity reactions should be available.

Can you take Remicade with Abatacept?

Concurrent use of REMICADE® with anakinra, abatacept, tocilizumab, or other biologics used to treat the same conditions as REMICADE® is not recommended because of the possibility of an increased risk of infection. Care should be taken when switching from one biologic to another, since overlapping biological activity may further increase the risk of infection.

Can remicade cause liver failure?

Severe hepatic reactions, including acute liver failure, jaundice, hepatitis, and cholestasis have been reported in patients receiving REMICADE® postmarketing. Some cases were fatal or required liver transplant. Aminotransferase elevations were not noted prior to discovery of liver injury in many cases. Patients with symptoms or signs of liver dysfunction should be evaluated for evidence of liver injury. If jaundice and/or marked liver enzyme elevations (eg, ≥5 times the upper limit of normal) develop, REMICADE® should be discontinued, and a thorough investigation of the abnormality should be undertaken.

Does remicade cause cervical cancer?

A population-based retrospective cohort study found a 2- to 3-fold increase in the incidence of invasive cervical cancer in women with rheumatoid arthritis treated with REMICADE® compared to biologics-naïve patients or the general population, particularly those over 60 years of age. A causal relationship between REMICADE® and cervical cancer cannot be excluded. Periodic screening should continue in women treated with REMICADE®.

Can you die from remicade?

Patients treated with REMICADE® (infliximab) are at increased risk for developing serious infections that may lead to hospitalization or death. Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. Discontinue REMICADE® if a patient develops a serious infection or sepsis.

What is The Patient Assistance Program?

The Johnson & Johnson Patient Assistance Foundation, Inc. (JJPAF) is an independent, non-profit organization that is committed to helping eligible patients without insurance coverage receive prescription products donated by Johnson & Johnson operating companies.

Program Update

Patients may now choose the option of electronic income verification. Instead of submitting a copy of their Federal tax return, they can simply check a box on the updated application form.

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