Rybrevant

Indicated For

Non-small cell lung cancer

About This Medication

# J&J withMe Savings Program Patient Guide: How to Get Rybrevant at Low or No Cost ## About This Program The J&J withMe Savings Program, along with the Johnson & Johnson Patient Assistance Program, is designed to help patients access Rybrevant (amivantamab-vmjw) regardless of their ability to pay. Rybrevant is a bispecific antibody used to treat non-small cell lung cancer. These programs can help reduce your out-of-pocket costs through copay assistance, free medication, or both. ## About Rybrevant Rybrevant is a prescription medication used to treat certain types of non-small cell lung cancer (NSCLC). It works by targeting specific mutations in cancer cells to help slow or stop the growth of your cancer. Because this is a specialty biologic medication, it can be expensive. These assistance programs exist to ensure cost is not a barrier to your treatment. ## Who Can Qualify? You may qualify for this program if you: - Are a U.S. resident - Have a valid prescription for Rybrevant from your healthcare provider - Are commercially insured, have Medicare or Medicaid, are underinsured, or are uninsured - Meet the income eligibility requirements (see chart below) - Authorize your medical information to be shared with the program ## Income Eligibility Guidelines Income limits vary based on your household size. The program is designed to help patients at various income levels, with special consideration for those below 200-400% of the Federal Poverty Level, though some assistance may be available at higher incomes. | Household Size | Maximum Annual Income | |---|---| | 1 person | $50,000 | | 2 people | ~$67,500 | | 3 people | ~$85,000 | | 4 people | ~$102,500 | | 5 people | ~$120,000 | | 6 people | ~$137,500 | | Each additional person | +$17,500 | *Note: Income thresholds may vary. Contact the program for exact limits that apply to your situation.* ## Insurance Requirements The program accepts applications from patients with: - **Commercial Insurance** (private health plans) - **Medicare** (including Medicare Advantage) - **Medicaid** - **Underinsured patients** (those with insurance but high copays or deductibles) - **Uninsured patients** (those without any health insurance) If you have insurance, you must typically exhaust your insurance coverage first, but the program can help with copays, coinsurance, and deductibles. ## Step-by-Step Application Instructions ### Step 1: Gather Required Documents Before you start, collect the following: - Your valid prescription for Rybrevant from your healthcare provider - Insurance information (insurance card, member ID, group number) if you have coverage - Proof of income (recent tax return, pay stubs, or benefit statements) - A completed Medical Information Authorization Form - Contact information for your healthcare provider ### Step 2: Apply Online Visit the program website at: **https://www.janssencarepath.com/patient/rybrevant/withme/cost-support/** The online application is the primary method to apply. It typically takes 15-30 minutes to complete. You'll be asked to enter: - Personal information (name, date of birth, contact details) - Insurance information (if applicable) - Income information and household size - Medical information and your prescription ### Step 3: Submit Your Application After completing the online form, submit it. You may receive a confirmation number—save this for your records. ### Step 4: Wait for Approval The program typically processes applications within **2-4 weeks**. You may receive updates via email or phone during this time. Be prepared to provide additional information if requested. ### Step 5: Receive Your Approval Once approved, you'll receive details about your specific benefits. This may include: - A copay card (reduced out-of-pocket costs) - Free medication (if uninsured or in financial hardship) - Coverage of deductibles or coinsurance ### Step 6: Get Your Medication Your approved Rybrevant will be **shipped directly to you** or to your healthcare provider's office, depending on program arrangement. Follow the storage and administration instructions provided. ## Timeline and What to Expect - **Application submission**: Same day online - **Processing time**: 2-4 weeks for approval decision - **Delivery**: Medication is shipped to you once approved - **Continuous coverage**: Program benefits continue as long as you remain eligible - **Reauthorization**: You must reapply **annually** to maintain benefits ## Additional Savings Options ### Rybrevant Savings Card Even if you don't qualify for the full patient assistance program, you may be eligible for the J&J Rybrevant Savings Card, which can reduce your copays. Visit: **https://www.janssencarepath.com/patient/rybrevant/withme/cost-support/** ## Reauthorization: Staying on the Program Your assistance benefits require **annual reauthorization**. You'll receive a reminder when it's time to renew. To maintain benefits: 1. Submit updated financial and medical information 2. Confirm you still have a valid prescription 3. Verify your eligibility status hasn't changed Reauthorization typically takes 2-4 weeks, so plan ahead before your current benefits expire. ## What If Your Application Is Denied? If you don't initially qualify, you have options: 1. **Request reconsideration**: Ask if additional financial documentation can be submitted 2. **Explore alternatives**: - Contact your insurance company about appeals or exceptions - Ask your healthcare provider about samples or clinical trials - Look into state pharmaceutical assistance programs - Visit NeedyMeds.org for additional resources 3. **Call for assistance**: Speak with a program representative who may identify other options ## How to Get Help **Phone Support**: (833) 792-7382 - Call Monday-Friday for application help - Representatives can answer questions about eligibility - Can assist with reauthorization **Online**: https://www.janssencarepath.com/patient/rybrevant/withme/cost-support/ - Complete applications online - Track your application status - Access program information **Your Healthcare Provider**: Your doctor's office can: - Help with the application process - Provide required documentation - Advocate for your coverage needs ## Important Reminders - **Keep your information updated**: Let the program know if your address, insurance, or income changes - **Don't miss reauthorization deadlines**: Set a reminder 30 days before your annual renewal - **Save documentation**: Keep records of your application, approval letters, and program correspondence - **This program doesn't replace insurance**: If you have insurance, the program works alongside your coverage, typically helping with copays and deductibles - **Confidentiality**: Your information is protected and used only for program eligibility purposes ## Legal Disclaimer This guide is informational only and not a substitute for official program rules or your healthcare provider's advice. Program eligibility, benefits, and requirements may change. Always refer to the official Johnson & Johnson Patient Assistance Program documents or contact the program directly for the most current information. The decision to use this medication should be made with your healthcare provider. This guide does not constitute medical or legal advice.

Program information last verified: March 25, 2026