Rezolsta

Johnson & Johnson Patient Assistance Program: How to Get Rezolsta at Low or No Cost

About This Program

The Johnson & Johnson Patient Assistance Program helps eligible patients access Rezolsta (darunavir/cobicistat) at no cost for up to one year when facing access and affordability challenges. This program is designed to ensure that financial constraints do not prevent you from receiving the HIV treatment your doctor has prescribed.

About Rezolsta

Rezolsta is a combination antiretroviral medication containing darunavir and cobicistat, used to treat HIV-1 infection in adults. Darunavir is a protease inhibitor, and cobicistat is a pharmacokinetic booster that helps maintain effective medication levels in your body. This combination helps suppress HIV and improve immune function when taken as directed by your healthcare provider.

Who Qualifies for This Program?

You may be eligible to receive Rezolsta at no cost if you meet these requirements:

• You are a U.S. resident or Puerto Rico resident
• You have commercial insurance, employer-sponsored insurance, Medicare, Medicaid, TRICARE, U.S. Department of Veterans Affairs health care, or U.S. Department of Defense health care
• Your current insurance does not fully cover your medication needs, creating access or affordability challenges
• You meet the program's income requirements (see Income Eligibility section below)
• For Medicare Part D patients: You are not eligible for the Low-Income Subsidy (LIS) and spend more than 4% of your gross annual household income on prescription drugs

You may also qualify if you are uninsured.

Income Eligibility

The program bases eligibility on household income compared to the Federal Poverty Level (FPL). While specific income thresholds were not detailed in available program materials, the following guidelines apply:

When you apply, you will need to provide your household income information unless you choose to participate without sharing income details. The program will verify your eligibility based on your specific situation.

Insurance Requirements

This program is designed for patients with:

• Commercial or employer-sponsored insurance plans (including Health Insurance Marketplace plans)
• Government insurance (Medicare, Medicaid, TRICARE, VA, or DoD coverage)
• No insurance coverage

Your insurance must not be subject to an "Assistance Diversion Program," which prohibits manufacturer assistance. Your insurer may need to submit a Patient Eligibility Certification form to confirm this.

How to Apply: Step-by-Step

Step 1: Gather Required Documents

Before starting your application, have the following information ready:

• Your insurance information (policy number, group number, member ID)
• Your healthcare provider's contact information
• Your prescription for Rezolsta (signed by your doctor)
• Proof of household income (recent tax return, pay stubs, or benefit statements)
• For Medicare Part D patients: pharmacy receipt or Explanation of Benefits (EOB) showing your out-of-pocket costs

Step 2: Complete the Patient Assistance Enrollment Form

You can download the enrollment form from the program website or request it during the application process. Your doctor must complete and sign the prescription information section of this form. You can either:

• Upload the completed form during online enrollment, or
• Fax it to 833-512-0497

Step 3: Submit Your Application

You have two options:

1. Online: Visit JJPatientAssistance.com and complete the enrollment process
2. Phone: Call 833-742-0791 (Monday–Friday, 8:00 AM–8:00 PM ET) to speak with a J&J withMe coordinator who can guide you through the application

Step 4: Verification and Approval

The program will:

• Verify your insurance coverage
• Check your eligibility for the assistance program
• Confirm that your insurance is not subject to an Assistance Diversion Program
• Review your income information
• Determine your eligibility status

Timeline and Delivery

While specific processing timeframes were not detailed in program materials, you should expect:

• Application processing: Several business days to 2 weeks, depending on completeness of your submission and insurance verification
• Medication delivery: Once approved, Rezolsta will be provided at no cost to you
• Program duration: Coverage for up to one year from approval date
• Reauthorization: You may need to reapply after one year if you continue to meet eligibility requirements

Contact the program at 833-742-0791 for specific information about your application status.

Important Program Terms and Conditions

• Medication cost only: This program covers the cost of Rezolsta only; it does not cover the cost of administering or monitoring your treatment
• No double assistance: You cannot seek payment for the value of this assistance from any health plan or patient assistance foundation
• Uninsured patients: If you are uninsured, the program will provide your medically necessary medication while you complete the assistance application
• Ending participation: You can end your participation at any time by calling 833-742-0791

What If Your Application Is Denied?

If you are not approved for the Johnson & Johnson Patient Assistance Program, consider these alternatives:

• Janssen CarePath Savings Program: May offer cost support for out-of-pocket expenses if you have insurance
• Medicine Assistance Tool (MAT): Visit MAT.org to search for other financial assistance resources available through various biopharmaceutical companies
• Patient assistance foundations: Independent organizations may offer additional support
• Healthcare provider resources: Your doctor or clinic may have information about other assistance programs
• Reapplication: If your circumstances change (income, insurance status), you may reapply

Contact J&J withMe coordinators at 833-742-0791 for help identifying alternative resources.

Disclaimer

This guide provides general information about the Johnson & Johnson Patient Assistance Program for Rezolsta. Program details, eligibility requirements, and terms may change. For the most current and complete information, visit JJPatientAssistance.com or call 833-742-0791. Always consult with your healthcare provider about your treatment options and medication access. This information is not a guarantee of program eligibility or approval.