Balversa

Indicated For

urothelial carcinoma, bladder cancer

About This Medication

# J&J withMe Savings Program Patient Guide: How to Get Balversa (erdafitinib) at Low or No Cost Balversa (erdafitinib) is a prescription medication used to treat adults with locally advanced or metastatic bladder cancer (urothelial carcinoma) with specific FGFR3 genetic alterations after progression on other treatments. The **J&J withMe Savings Program**, offered by Janssen (a Johnson & Johnson company), helps eligible patients pay just **$5 per fill** for Balversa, covering copays, coinsurance, or deductibles.[1][2][3] ## About Balversa and Why Assistance Matters **Balversa** is an oral kinase inhibitor that targets fibroblast growth factor receptor (FGFR) alterations in bladder cancer cells, helping to slow cancer growth in patients whose disease has progressed after platinum chemotherapy or who cannot tolerate it.[4][6] As a specialty medication dispensed through pharmacies like CVS Specialty, it can be expensive without support—often thousands of dollars per month. High costs can lead to treatment delays or discontinuation, which is why programs like J&J withMe exist to make it accessible.[2][3] This guide explains eligibility, application steps, and more in simple terms. It's patient-friendly, but always consult your doctor or pharmacist for personalized advice. ## Who Qualifies for the J&J withMe Savings Program? This program is designed for patients with **commercial or private insurance** (not government programs). Key qualifications include: - A valid prescription for Balversa from your healthcare provider (HCP). - Coverage under a commercial health plan (e.g., employer-sponsored insurance). - No enrollment in Medicare, Medicaid, or other federal/state government-funded programs.[1][2][3] **No income requirements**—patients can participate without sharing financial details, making it accessible to a wide range of people.[2][3] There may be monthly maximums and an annual benefit cap, and terms reset each calendar year. The offer can change or end without notice.[1][3] ## Income Eligibility Breakdown Unlike traditional patient assistance programs, the J&J withMe Savings Program has **no income thresholds**. It's open to all eligible commercially insured patients regardless of earnings. For context, third-party services like Prescription Hope have income limits (e.g., under $200,000/year for families), but Janssen's official program does not.[5] | Household Size | Income Threshold | Notes | |---------------|------------------|-------| | Individual | None | No income check required.[2][3] | | Couple | None | Open to all commercial insurance holders. | | Family of 3 | None | Annual benefit limits apply. | | Family of 4+ | None | Check program site for details. | If you're uninsured or on government insurance, explore alternatives like Janssen's broader support, Prescription Hope ($60/month flat fee, income-based), PAN Foundation, HealthWell, or state programs.[5][9] ## Insurance Requirements - **Must have commercial/private insurance**; government programs (Medicare, Medicaid) are excluded.[1][2][3] - Your plan must cover Balversa (many do for eligible FGFR3+ cases).[2] - Specialty pharmacy (e.g., CVS Specialty, ASD Healthcare) handles verification, prior authorizations (PA), and appeals if needed.[2][3] - If your insurer requires PA, your HCP provides a Letter of Medical Necessity with clinical details like FGFR3 status and prior treatments.[3][6] Medicare patients may qualify for Extra Help (Low-Income Subsidy) or Part D plans with low copays, but not this Janssen program.[2][7] ## Step-by-Step Application Process 1. **Discuss with Your Doctor**: Confirm Balversa is right for you. Your HCP submits the prescription to a specialty pharmacy like CVS Specialty.[2][3] 2. **Check Eligibility**: Visit Balversa.JNJwithMeSavings.com or call Janssen CarePath at the number on the site. No income proof needed.[1][3] 3. **Enroll in Savings Program**: Your provider or pharmacy can enroll you instantly. Use the program card for $5 fills at the pharmacy.[1][2] 4. **Pharmacy Coordination**: The specialty pharmacy verifies coverage, handles PA if required, and ships medication. They may request documents like proof of insurance.[3] 5. **Receive Medication**: Pick up or get home delivery. Pay $5 per fill (subject to caps).[1] Applications are quick—often instant for savings card activation.[3] ## Timeline and Delivery - **Approval/Enrollment**: Instant for savings if eligible; PA may take days to weeks depending on insurer.[3][6] - **First Shipment**: 2-4 weeks after approval via specialty pharmacy.[5] - **Refills**: Monthly, with adherence support from pharmacy. Reauthorization needed annually or if disease progresses (no progression evidence required).[3][6] - **Delivery**: Home shipment coordinated by pharmacy; track via their portal.[2] ## Alternatives if Denied or Ineligible - **Appeal Denial**: Use checklists for insurance appeals or exceptions; include Prescribing Info and guidelines.[2][3] - **Government Insurance Users**: Apply for Medicare Extra Help, state programs, or LIS.[2][7] - **Uninsured/Low-Income**: Prescription Hope ($60/month, income < $200k), PAN Foundation, HealthWell Copay Program, Patient Advocate Foundation.[5][9] - **Other Janssen Tools**: Know Your State tool for local aid.[2] Shop around—GoodRx or pharmacy discounts may help too.[7] ## Important Disclaimer This guide is for informational purposes based on available program details as of general knowledge. Eligibility, terms, and availability can change—always verify at official sites like JNJwithMe.com or Balversa.JNJwithMeSavings.com. Not medical advice; consult your healthcare team. Janssen does not guarantee coverage or savings. Program excludes government insurance and has restrictions.[1][2][3] Word count: 942.

Program information last verified: March 30, 2026