Zejula

Indicated For

ovarian cancer, fallopian tube cancer, peritoneal cancer

About This Medication

# GSK Oncology Patient Assistance Program Patient Guide: How to Get Zejula (niraparib) at Low or No Cost Zejula (niraparib) is a prescription medication used as a maintenance treatment for adults with advanced ovarian, fallopian tube, or primary peritoneal cancer who are in complete or partial response to first-line platinum-based chemotherapy or have recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer that is responsive to platinum-based chemotherapy. The **GSK Oncology Patient Assistance Program** helps eligible uninsured, underinsured, or Medicare patients get **Zejula** at no cost if they meet income and other requirements. ## Who Qualifies for the Program? This program is designed for patients facing financial hardship who cannot afford their medications. Key eligibility factors include: - **Residency**: You must live in the United States. - **Insurance status**: Uninsured, underinsured, or enrolled in Medicare (including Medicare Part D). - **Income limits**: Based on household size, with specific thresholds for Medicare patients (detailed below). - **Prescription**: A valid prescription for Zejula from your healthcare provider. - **No alternatives**: You must not have access to other funding sources that fully cover the medication. The program does not cover patients with commercial insurance that fully pays for Zejula or those above income limits. GSK may verify income using consumer reports from public sources. ## About Zejula (niraparib) **Zejula** is an oral PARP inhibitor capsule taken once daily. It helps block cancer cells from repairing their DNA, slowing tumor growth. Common uses include: - Maintenance therapy after initial chemotherapy for ovarian cancer. - Treatment for recurrent ovarian cancer responsive to platinum therapy. Always take as prescribed by your doctor. Side effects may include low blood cell counts, nausea, fatigue, and high blood pressure—discuss with your healthcare team. This guide focuses on access, not medical advice. ## Income Eligibility Breakdown Income limits apply primarily to Medicare patients. Thresholds are annual pre-tax household income. Add **$12,000 per additional family member** beyond the listed sizes. Medical expenses may adjust eligibility—provide proof if applicable. | Household Size | Annual Income Limit (Medicare Patients) | |----------------|-----------------------------------------| | Individual | $48,000 | | Couple | $60,000 | | Family of 3 | $72,000 | | Family of 4 | $84,000 | **Example**: A family of 5 would have a limit of $84,000 + $12,000 = $96,000. Report total gross household income, including all members living together. GSK may request verification. ## Insurance Requirements - **Eligible**: Uninsured, underinsured (high copays/deductibles), or Medicare patients (Part D proof required). - **Ineligible**: Patients with active commercial insurance covering Zejula fully, Medicaid, or other government programs that pay 100%. For Medicare Part D, submit proof of coverage and Low-Income Subsidy (LIS) status if applicable. The program coordinates with your benefits to bridge gaps. ## Step-by-Step Application Process 1. **Talk to your doctor**: Ask them to complete the enrollment form. They select services and provide clinical info (diagnosis, ICD-10 code). 2. **Gather documents**: - Proof of residency (utility bill, lease). - Proof of income (tax returns, pay stubs, W-2s for all household members). - Medicare prescription drug coverage proof (Part D card, Explanation of Benefits). - Signed prescription for Zejula. - Patient and prescriber signatures. 3. **Complete the form**: Use the Together with GSK Oncology Enrollment Form (available via your doctor or call 1-844-447-5662). Include household size, income, and optional PAP enrollment. 4. **Submit by fax**: Fax to the number on the form (e.g., 1-844-475-4662 or 1-800-645-9043). Include insurance cards. 5. **Wait for contact**: GSK confirms receipt next business day, calls your doctor, and contacts you within 2 business days for benefits summary. Your doctor or advocate must help—patients cannot apply alone. ## Timeline and Delivery - **Processing**: 2-12 business days. - **Confirmation**: Next business day to provider; 1-2 days to patient. - **Delivery**: Free medication shipped to your home or doctor's office. Program schedules shipments before treatment dates. Refills not automatic—request via phone/online/portal. Track status by calling **(844) 447-5662** (Mon-Fri, 8 AM-8 PM ET). ## Alternatives if Denied or Ineligible - **Reapply**: Fix issues (e.g., missing docs) and resubmit. - **Co-pay Program**: If commercially insured, check Together with GSK Oncology Co-pay Program (up to $15,000/year assistance). - **Other PAPs**: PAN Foundation, HealthWell Foundation, or Patient Access Network for ovarian cancer. - **State programs**: Check Medicaid extra help or state pharmaceutical aid. - **Manufacturer hub**: Call GSK for bridging therapy or samples. No biosimilar alternatives for Zejula currently. ## Important Disclaimer This guide is for informational purposes based on program details as of latest available data. Eligibility, terms, and income limits can change—verify with GSK at (844) 447-5662 or TogetherwithGSKOncology.com. Not medical/financial advice. Consult your doctor for treatment; a financial advisor for income questions. GSK makes final decisions. Applications must be truthful—false info may disqualify you. HIPAA authorization required for processing. Word count: 1028.

Program information last verified: March 25, 2026