OPSUMIT

Indicated For

Pulmonary arterial hypertension (PAH)

About This Medication

# Johnson & Johnson Patient Assistance Program Patient Guide: How to Get OPSUMIT at Low or No Cost ## About This Program The Johnson & Johnson Patient Assistance Program helps eligible patients access OPSUMIT (macitentan) at no cost or reduced cost. OPSUMIT is a prescription medication used to treat pulmonary arterial hypertension (PAH), a serious condition affecting blood flow in the lungs. If you're struggling to afford this medication, this program may help you get the treatment you need. ## Who Qualifies for This Program? You may be eligible for the Johnson & Johnson Patient Assistance Program if you meet these requirements: **Insurance Status** You qualify if you are: - Uninsured (have no health insurance coverage), OR - Underinsured with commercial, employer-sponsored, or government insurance that does not fully cover OPSUMIT This includes patients with Medicare, Medicaid, or private insurance plans that leave you with high out-of-pocket costs. **Residency** You must live in the United States or a U.S. territory. **Prescription Requirements** Your medication must be prescribed by a U.S.-licensed physician for outpatient use. ## Income Eligibility While specific income thresholds for OPSUMIT are not publicly listed, the Johnson & Johnson Patient Assistance Program generally considers household income when determining eligibility. Income limits vary based on family size and the specific medication. The program evaluates your financial situation comprehensively, not just income alone. If you're unsure whether your income qualifies, the program staff can review your situation during the application process. Many patients with moderate incomes still qualify, especially if they have significant out-of-pocket medication costs. ## Insurance Requirements Explained **If You Have No Insurance** You may receive OPSUMIT at no cost for up to one year if you meet other eligibility requirements. **If You Have Commercial or Employer-Sponsored Insurance** You may qualify if your insurance doesn't fully cover OPSUMIT or if your out-of-pocket costs are substantial. The program can help bridge the gap between what your insurance covers and the full cost. **If You Have Medicare or Medicaid** You may be eligible, particularly if you're spending a significant portion of your income on prescription medications. Medicare Part D patients may need to provide documentation of their out-of-pocket costs. **If You Have Government Insurance** Government-sponsored plans (including state programs) may qualify you for assistance if coverage is insufficient. ## How to Apply: Step-by-Step **Step 1: Gather Your Information** Before calling, have the following ready: - Your insurance information (if applicable) - Your healthcare provider's contact information - Your prescription for OPSUMIT - Proof of income (such as recent tax returns or pay stubs) - Your Social Security number - Your date of birth and address **Step 2: Call the Program** Contact the Johnson & Johnson Patient Assistance Program at **(866) 228-3546**. This is the dedicated phone line for OPSUMIT assistance. Program hours are Monday through Friday, 8:00 AM to 8:00 PM ET. **Step 3: Complete Your Application** A program representative will guide you through the application process over the phone. They will ask about: - Your medical history and current OPSUMIT prescription - Your insurance coverage (or lack thereof) - Your household income and family size - Your financial situation **Step 4: Submit Required Documentation** You may be asked to submit: - Copies of insurance cards (front and back) - Proof of income (recent tax returns, pay stubs, or other financial documents) - A completed enrollment form signed by your healthcare provider - Proof of residency (if requested) Documentation can typically be submitted by fax, mail, or online portal, depending on the program's current processes. **Step 5: Eligibility Determination** The program will review your application and determine your eligibility. They will contact you with the decision. **Step 6: Receive Your Medication** Once approved, OPSUMIT will be shipped directly to your home or to your healthcare provider's office, as you prefer. ## Timeline and Delivery **Processing Time** While specific processing times are not guaranteed, most applications are reviewed within 1-2 weeks of submission. Complex cases may take longer. **Medication Delivery** Once approved, your medication is shipped directly to you. You can choose to have it delivered to: - Your home - Your prescriber's office - Your treatment center Shipping is included at no cost to you. **Reauthorization** You will need to reauthorize your enrollment periodically (typically annually) to continue receiving assistance. The program will contact you when it's time to renew. ## What If Your Application Is Denied? If you don't qualify for the Johnson & Johnson Patient Assistance Program, you have other options: - **Ask about alternative programs**: The program may refer you to independent foundations that provide financial assistance to patients in need. - **Explore other manufacturer programs**: Other pharmaceutical companies may offer assistance for similar medications. - **Contact patient advocacy organizations**: Organizations focused on pulmonary hypertension may have resources or additional assistance programs. - **Speak with your healthcare provider**: Your doctor may know of clinical trials, hospital assistance programs, or other resources. - **Reapply if circumstances change**: If your financial situation changes, you can reapply to the program. ## Important Disclaimers - This program provides medication cost assistance only and does not cover the costs of medical visits, lab work, or other treatment-related expenses. - Eligibility requirements and program details may change. Always verify current requirements by calling the program directly. - The information provided here is based on general program guidelines. Your specific eligibility will be determined during the application process. - This guide is not a substitute for professional medical or financial advice. Consult with your healthcare provider or financial advisor if you have questions about your specific situation. - Enrollment in this program does not affect your credit score, though the program may perform a credit check as part of the application process. ## Contact Information **Johnson & Johnson Patient Assistance Program for OPSUMIT** - **Phone**: (866) 228-3546 - **Hours**: Monday–Friday, 8:00 AM–8:00 PM ET - **Website**: Visit JJPatientAssistance.com for additional resources Don't let cost prevent you from getting the medication you need. Call today to learn if you qualify.

Program information last verified: March 25, 2026