Razadyne ER

Indicated For

Mild to moderate dementia, Alzheimer's disease

About This Medication

# Johnson & Johnson Patient Assistance Foundation, Inc. Patient Guide: How to Get Razadyne ER at Low or No Cost ## About This Program The Johnson & Johnson Patient Assistance Foundation, Inc. Patient Assistance Program helps eligible patients receive Razadyne ER (galantamine) at no cost for up to one year if they meet specific financial and insurance requirements.[1][6] This program is designed to ensure that cost does not prevent you from accessing the medication your doctor has prescribed. ## Who Can Qualify? To be eligible for this program, you must meet all of the following requirements: - **Live in the United States or a U.S. territory** (including Puerto Rico)[7] - **Have a valid prescription** for Razadyne ER from a U.S.-licensed physician for outpatient use[7] - **Meet financial eligibility criteria** based on your household income and family size[7] - **Have no insurance or insurance that does not fully cover your prescription costs**, including certain Medicare Part D enrollees[7] ## Income Eligibility Financial eligibility is determined on a case-by-case basis and depends on your household income and family size.[3] While specific income thresholds are not publicly listed, the program uses a needs-based assessment to determine if you qualify. **Important note for Medicare Part D patients:** If you have Medicare Part D coverage, you may still qualify if you spend more than 4% of your gross annual household income on prescription drugs and are not eligible for the Low-Income Subsidy (LIS).[3] ## Insurance Requirements You may qualify if you: - Have no prescription drug insurance[7] - Have commercial or employer-sponsored insurance that does not fully cover your medication costs[8] - Are enrolled in Medicare Part D and meet the spending threshold mentioned above[3] - Have Medicaid or other government coverage that does not fully meet your needs[8] The program specifically helps patients facing access and affordability challenges, regardless of their insurance status.[8] ## How to Apply Following these steps will help you enroll in the program: **Step 1: Gather Required Information** Before starting your application, have the following ready:[3] - Your insurance information (copies of front and back of all insurance cards) - Proof of income (most recent 1040 or 1040-SR Federal tax return, or for Puerto Rico residents, acceptable financial documentation) - Your healthcare provider's information - Your prescription information for Razadyne ER **Step 2: Complete the Patient Assistance Enrollment Form** Download the Patient Assistance Enrollment Form from the Johnson & Johnson website.[2][5] Complete all sections on page 2 and sign the form. You will also need to review and sign the Patient Authorization Form and Terms of Participation (pages 4-7).[5] Alternatively, you can sign the Patient Authorization Form online at JanssenPatientAssistance.com/PA if you prefer not to print and sign the form.[2] **Step 3: Have Your Doctor Complete the Form** Ask your healthcare provider to complete and sign page 3 of the enrollment form. If you take multiple J&J medications, your doctor will need to complete a separate page 3 for each medication.[2][5] **Step 4: Submit Your Application** You have two options for submission: - **Online:** Visit JJPatientAssistance.com or Portal.JNJwithMe.com to upload your completed form and supporting documents - **Fax:** Send your completed form and supporting documents to 1-833-512-0497[5] Make sure to include all required supporting documents with your application to avoid processing delays.[2] **Step 5: Await Approval** Johnson & Johnson will review your application, determine your insurance coverage, and check your eligibility for the program. You and your healthcare provider will receive updates on your enrollment status.[3] ## Timeline and Medication Delivery While specific processing times are not publicly stated, the program aims to process applications efficiently. Once approved, your Razadyne ER will be shipped to you at no cost.[1][6] The program provides medication assistance only and does not cover the costs of medical treatment or administration. ## What If Your Application Is Denied? If you are not approved for the Johnson & Johnson Patient Assistance Program, you have additional options: - **Explore other assistance programs:** Johnson & Johnson partners with independent foundations that may provide financial support to patients in need.[9] - **Use the Medicine Assistance Tool (MAT):** Visit MAT.org to search for other financial assistance resources available through various biopharmaceutical industry programs.[4] - **Contact patient advocates:** Organizations like Simplefill can help you identify alternative assistance programs if you do not qualify for J&J's program.[7] ## Reauthorization and Renewal Your assistance is provided for up to one year.[1][6] Before your year of assistance ends, you will need to reapply for continued support if you still need help paying for your medication. Johnson & Johnson will guide you through the renewal process. ## Getting Help If you have questions about the program or need assistance completing your application, contact Johnson & Johnson Patient Assistance: - **Phone:** 1-833-742-0791 - **Hours:** Monday through Friday, 8:00 AM to 8:00 PM ET[2][5] - **Online:** Visit JJPatientAssistance.com or Portal.JNJwithMe.com ## Important Disclaimer This guide provides general information about the Johnson & Johnson Patient Assistance Program for Razadyne ER. Program eligibility, requirements, and benefits may change. For the most current and complete information, visit the official program website or call the phone number listed above. Always consult with your healthcare provider about your treatment options and financial assistance eligibility.

Program information last verified: March 30, 2026