Yondelis

Indicated For

soft tissue sarcoma, ovarian cancer

About This Medication

# Janssen Patient Assistance Program Patient Guide: How to Get Yondelis at Low or No Cost ## About This Program The Janssen Patient Assistance Program helps eligible patients access their prescribed Janssen medications, including Yondelis (trabectedin), at no cost for up to one year. This program is designed for patients who struggle to afford their medications due to financial hardship, even with insurance coverage. ## Who Qualifies for This Program? To be eligible for the Janssen Patient Assistance Program, you must meet all of the following requirements: - **Live in the United States or a U.S. territory** - **Be treated as an outpatient by a licensed U.S. healthcare provider** - **Have a valid prescription for Yondelis from your doctor** - **Meet the income eligibility requirements** (specific thresholds vary by medication) - **Have insurance coverage that does not fully meet your medication needs**, or have no insurance and have exhausted all other free or low-cost options - **For Medicare Part D patients only:** Spend more than 4% of your gross annual household income on prescription drugs ## Income Eligibility The Janssen Patient Assistance Program uses income-based eligibility criteria to determine who qualifies. While specific income thresholds for Yondelis are not publicly listed, the program generally considers your household income and family size. You will need to provide proof of your current income when you apply. If you are unsure whether your income qualifies, the program staff can review your financial situation during the application process. It's better to apply and let them determine eligibility than to assume you don't qualify based on income alone. ## Insurance Requirements You may qualify for this program if: - You have commercial or employer-sponsored insurance that doesn't fully cover Yondelis - You have government insurance (Medicare, Medicaid) that leaves you with significant out-of-pocket costs - You have no insurance and have applied to all available free or low-cost insurance options If you have Medicare Part D coverage, you'll need to show that your out-of-pocket prescription drug costs exceed 4% of your gross annual household income. You can demonstrate this with a pharmacy report or an Explanation of Benefits (EOB) statement from your insurance company. ## What You'll Need to Apply Before you start the application process, gather these documents: | Document | Purpose | Notes | |----------|---------|-------| | Proof of Income | Verify financial eligibility | Most recent Federal tax return (Form 1040 or 1040-SR) | | Insurance Information | Confirm coverage details | Front and back copies of all insurance cards (medical, pharmacy, etc.) | | Valid Prescription | Confirm medication need | Must be signed by your healthcare provider | | Proof of Residency | Verify U.S. residence | May be required; check with program staff | | Medicare/EOB Statement | For Medicare Part D patients | Pharmacy report or EOB showing out-of-pocket costs for current year | ## How to Apply: Step-by-Step **Step 1: Complete the Patient Assistance Enrollment Form** Download the Patient Assistance Enrollment Form from the Janssen website or request it by phone. You and your caregiver should complete pages 2-5, including the Patient Authorization section. Your healthcare provider will need to complete the remaining pages and sign the prescription information section. **Step 2: Gather Your Supporting Documents** Collect all required documents listed above. Having everything ready before you submit will speed up processing. **Step 3: Submit Your Application** You have two options: - **Fax:** Send your completed form and supporting documents to 1-833-512-0497 - **Phone:** Call 1-833-742-0791 (Monday-Friday, 8:00 AM to 8:00 PM ET) to discuss your application and submit information **Step 4: Wait for Eligibility Determination** The program will review your application, verify your insurance coverage, and determine your eligibility. You and your healthcare provider will receive updates on your application status. **Step 5: Receive Your Medication** Once approved, your Yondelis will be shipped directly to you or your physician's office, depending on what works best for your treatment plan. ## Application Timeline and Delivery The program does not publicly specify an exact processing timeline, but submitting a complete application with all required documents will help avoid delays. Incomplete applications may take longer to process. Once you're approved, your medication will be delivered to either your home or your healthcare provider's office. Discuss delivery preferences with the program staff when you apply. ## Reauthorization and Ongoing Participation Your assistance is available for up to one year. You may need to reauthorize your participation after this period if you continue to meet eligibility requirements. The program will notify you when reauthorization is needed. You must notify the Janssen Patient Support Program within 30 days if there are any changes to: - Your income - Your health insurance coverage - Your Medicare Part D enrollment status - Your age or disability status These changes may affect your continued eligibility. ## What If Your Application Is Denied? If you don't qualify for the Janssen Patient Assistance Program, ask the program staff about alternative options: - **Other Janssen programs** that may better match your situation - **Manufacturer coupons or discounts** for Yondelis - **State pharmaceutical assistance programs** for low-income patients - **Non-profit organizations** that help patients afford cancer medications - **Clinical trials** that may provide free medication - **Hospital financial assistance programs** if you receive treatment at a medical center Your healthcare provider and the program staff can help you explore these alternatives. ## Important Terms and Conditions By participating in this program, you agree that: - All information you provide is complete and accurate - You meet the eligibility requirements - You are applying voluntarily (not directed by your insurance company) - You will not sell or trade the medication provided - You will notify the program of any changes in income or insurance within 30 days - You may end your participation at any time by calling the program ## Contact Information **Phone:** 1-833-742-0791 **Hours:** Monday-Friday, 8:00 AM to 8:00 PM ET **Fax:** 1-833-512-0497 Program staff can answer questions about eligibility, help you complete your application, and provide updates on your status. ## Disclaimer This guide provides general information about the Janssen Patient Assistance Program based on publicly available program materials. Eligibility requirements, income thresholds, required documents, and program terms may change. For the most current and accurate information specific to your situation, contact the program directly at the phone number above. This guide is not a guarantee of program eligibility or approval. Your individual circumstances will be reviewed by the program to determine final eligibility.

Program information last verified: March 30, 2026