ZEJULA

Indicated For

Advanced epithelial ovarian cancer, fallopian tube cancer, primary peritoneal cancer

About This Medication

# GSK Patient Assistance Program for ZEJULA Patient Guide: How to Get ZEJULA at Low or No Cost ZEJULA (niraparib) is a prescription medication used as maintenance treatment for adults with certain types of advanced ovarian, fallopian tube, or primary peritoneal cancer who have responded to platinum-based chemotherapy. The **GSK Patient Assistance Program (PAP)** offers ZEJULA at no cost to eligible uninsured, underinsured, or functionally uninsured patients meeting specific income and other criteria[1][2][6]. ## About ZEJULA (niraparib) ZEJULA is indicated for: - First-line maintenance treatment of adult patients with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in a complete or partial response to platinum-based chemotherapy and have **HRD-positive status** (defined by deleterious or suspected deleterious BRCA mutation and/or genomic instability)[1][4]. - Maintenance treatment after response to platinum-based chemotherapy in patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer[4][7]. **Important Safety Information**: Common side effects include low blood cell counts (thrombocytopenia, anemia, neutropenia), nausea, fatigue, constipation, and decreased appetite. Serious risks include **hypertension** (monitor blood pressure weekly initially), **myelodysplastic syndrome/acute myeloid leukemia (MDS/AML)**, and **posterior reversible encephalopathy syndrome (PRES)** (symptoms: seizure, headache, confusion—seek immediate medical help). Always discuss risks with your doctor[1][4][10]. ZEJULA comes as capsules taken orally once daily. Your doctor will determine the right dose, often starting at 300 mg and adjusting based on side effects like low blood counts[1]. ## Who Qualifies for the Program? The GSK PAP for ZEJULA, managed by the independent GSK Patient Access Programs Foundation (a 501(c)(3) charity separate from GSK), provides free medication to eligible patients. It's **not health insurance** and subject to change[2][6][9]. Key requirements: - U.S. resident with a valid prescription for ZEJULA. - Meet **income eligibility** (detailed below). - Uninsured, underinsured, or functionally uninsured (insurance doesn't cover ZEJULA—contact program for details)[6]. - Medicare and commercially insured patients have **separate eligibility thresholds and processes**; call for specifics[3][6]. Patients exceeding income limits **may still qualify** by showing eligible medical expenses that reduce their effective income (contact program for details)[6]. ## Income Eligibility Breakdown Income thresholds are based on **400% of the Federal Poverty Level (FPL)** for uninsured patients, with adjustments for households. Figures are annual gross income maximums[6]. ### Uninsured Patients | Household Size | Maximum Annual Gross Income | |---------------|-----------------------------| | 1 | $62,600 | | 2 | $84,600 | | 3 | $106,600 | | 4 | $128,600 | | Each additional | +$22,000 | **Medicare Patients** (separate table, higher thresholds)[3]: | Household Size | Maximum Annual Gross Income | |---------------|-----------------------------| | 1 | $78,200 | | 2 | $105,720 | | 3 | $133,240 | | 4 | $160,760 | | Each additional | +$27,520 | **Commercial Insurance**: Different thresholds apply—call (844) 447-5662 for details[6]. ## Insurance Requirements - **Primary focus**: Uninsured or functionally uninsured (no coverage for ZEJULA). - **Medicare patients**: Eligible via separate PAP track[3]. - **Commercially insured**: May qualify under different rules; program verifies coverage and offers alternatives like copay assistance if PAP ineligible[1][8]. - Provide insurance info (if any) during application. Program coordinators check benefits[5]. ## Step-by-Step Application Process 1. **Talk to your healthcare provider (HCP)**: They must complete part of the enrollment form confirming your diagnosis and prescription[5][8]. 2. **Download or request the form**: Visit [enrollment page](https://www.togetherwithgsk.com/zejula/patient/enroll/) or call **(844) 447-5662** (Together with GSK Oncology)[2][5]. 3. **Gather documents**: - Completed enrollment form (signed by HCP). - **Proof of income** (e.g., tax returns, pay stubs, W-2s for previous year). - Insurance info (if applicable, like Medicare card or denial letter)[6]. 4. **Submit**: Fax, mail, or upload per instructions. Multiple methods available[5]. 5. **Wait for contact**: A Patient Navigator reaches out with next steps[5]. **Tip**: Enroll early—Quick Start program helps with first-fill delays for eligible patients[8]. ## Timeline and Delivery - **Processing**: ~**12 business days** for summary benefits decision; **2 business days** for coverage info call[program details]. - Once approved, medication is **shipped free directly to you**. Program coordinates scheduling[program details]. - **Reauthorization required**: Submit annually or as needed to continue[program details]. ## Alternatives if Denied or Ineligible - **Exceed income?** Submit medical expense proof to potentially qualify[6]. - **Commercially insured?** Explore **Copay Program**, **Bridge Program** (for coverage gaps), or Quick Start[1][8]. - **Medicare?** Separate PAP or other GSK support[3]. - **Appeals**: Program helps with prior authorizations/appeals[8]. - **Other options**: State programs, generic alternatives (none currently), or patient foundations. Call program for personalized guidance. ## Refill Process Approved patients get refills shipped automatically. **Reauthorization** needed periodically—program notifies you. Ensure HCP updates prescription[program details][7]. ## Disclaimer This guide is for informational purposes only and based on program details as of last update. **Eligibility, terms, and income limits can change**. Programs do not constitute health insurance. Always verify with GSK at (844) 447-5662 or official sites. Consult your doctor for medical advice. GSK makes no representations about coverage or outcomes[2][6][9]. (Word count: 1028)

Program information last verified: March 30, 2026