Financial Assistance Options for Jakafi® (ruxolitinib)

Get more information about the Copay/Coinsurance Assistance Program for Jakafi and how eligible commercially/privately insured patients can receive their Jakafi for as little as $25/month. View the video to learn more.

Copay/Coinsurance Assistance for Jakafi® (ruxolitinib)

Often, health plans require you to make a copayment to help pay for the cost of your medicine. Your prescription drug plan sets the specific copayment amount.

Are you having trouble affording Jakafi because the copays or coinsurance is too high? Talk with an IncyteCARES oncology certified nurse. Offering a single point of contact throughout the program, our nurses provide assistance to help eligible patients find the right program to access Jakafi through several patient assistance options, including the following:

IncyteCARES can also refer patients to independent nonprofit organizations and foundations.

Based on patients diagnosed with an FDA-approved indication enrolled in IncyteCARES between June 2014 and June 2016:

97%

of commercially/privately insured patients referred to the copay/coinsurance assistance program were eligible for assistance

IncyteCARES Copay/Coinsurance Assistance Program: Eligible patients pay as little as $25 per month

If you have been prescribed Jakafi and have private or commercial prescription insurance, you may be eligible to receive Jakafi for as little as $25 per month, subject to monthly and annual limits.*† Review additional terms and conditions.

Patient Copay/Coinsurance Assistance Card

*Amount of savings for the purchase of Jakafi will not exceed $10,970 per month and $25,000 per year. Uninsured, cash-paying patients are not eligible. Not valid for patients covered under state or federally-funded healthcare programs. Valid prescription for Jakafi for an FDA-approved indication is required. Please see full criteria for eligibility below or call IncyteCARES.

Patients insured through Medicare, Medicaid, and TRICARE are not eligible.

Click here for enrollment criteria for IncyteCARES copay/coinsurance assistance.

Click here to learn how to enroll in the IncyteCARES Copay/Coinsurance Assistance Program.

Terms and Conditions for IncyteCARES Copay/Coinsurance Assistance Program

Terms and Conditions:

Amount of savings on Jakafi will not exceed $10,970 per month and $25,000 per year, limit one 30-day supply per 30 days. You must have minimum out-of-pocket cost of $25.01 to redeem this card and must contribute $25 towards that out-of-pocket cost. Card must be activated before use. Card is valid for one year after activation, after which time a card must be re-activated to continue use. You must be 18 years or older and have commercial or private insurance. Offer is not valid if you are uninsured or paying cash for your prescription. Offer is not valid if you are enrolled in a federal or state healthcare program (including Medicare, Medicaid, TRICARE, or any state medical or pharmaceutical assistance program). If you have any questions, please call 1-855-4-Jakafi (1-855-452-5234). This card is not insurance. Offer valid only if Jakafi used for an FDA-approved use. Jakafi is indicated for treatment of intermediate or high-risk myelofibrosis (MF), including primary MF, post–polycythemia vera MF and post–essential thrombocythemia MF. Jakafi is also indicated for treatment of patients with polycythemia vera who have had an inadequate response to or are intolerant of hydroxyurea. You are responsible for reporting receipt of program benefits to any commercial or private insurer that pays for or reimburses any part of the prescriptions filled with this program, to the extent required by law or by the insurer. You agree not to seek reimbursement from your insurer or any other third-party for all or any part of the benefit received through this offer.

This card may not be sold, purchased, traded, or transferred and is void if reproduced. One card per patient. No substitutions are permitted. Use of this card does not obligate you to use or continue to use Jakafi®. No other purchase and no refills are necessary. Cannot be combined with any other offer. You are responsible for all taxes. Program cards are the property of Incyte Corporation and must be turned in on request. Offer is good only in the 50 US States, the District of Columbia, and Puerto Rico, and void where prohibited or otherwise restricted by law. For Massachusetts residents, this offer will expire on July 1, 2017. Incyte Corporation reserves the right to rescind, revoke, or amend this program without notice.

IncyteCARES FINANCIAL ASSISTANCE OPTIONS

Get more information about how the IncyteCARES Program may help eligible patients who have no or limited drug coverage for Jakafi with the cost of their Jakafi. Also learn about how federally insured patients can get referred to an independent nonprofit organization or foundation for assistance. View the video to learn more.

FREE MEDICATION PROGRAM FOR JAKAFI

If you do not have prescription drug coverage for Jakafi, you may be eligible to receive Jakafi free of charge through the IncyteCARES Patient Assistance Program. This program helps people who do not have a prescription drug plan as well as those whose plans have turned them down for Jakafi treatment.

Certain conditions do apply for the free medication program. You may be eligible if you are a resident of the US or Puerto Rico and your household size and annual income meet certain criteria, including earning less than $125,000 a year or less than 600% of the Federal Poverty Level (FPL). In addition, patients insured through Medicare, Medicaid, TRICARE, and healthcare exchange plans are not eligible. An IncyteCARES oncology certified nurse can help determine if you’re eligible to receive your Jakafi for free through the Patient Assistance Program. Terms of the program are subject to change.

Temporary Access Program

Eligible patients experiencing coverage delays can receive a free supply of Jakafi. To be eligible, patients must submit a proof of insurance claim verifying the delay. Free product is offered to eligible patients without any purchase contingency or other obligation. For more information, contact an IncyteCARES registered nurse.

Financial Assistance Options FAQs

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Have a comment or question about IncyteCARES?

We welcome your feedback.

 An IncyteCARES oncology certified nurse may contact me regarding my question or comment.

Financial Assistance OPTIONS FAQs

Copay/Coinsurance Assistance Program FAQs

What are the enrollment criteria for copay/coinsurance assistance?

To qualify for the Copay/Coinsurance Assistance Program through IncyteCARES, you must meet the following criteria:
  • Have commercial or private insurance (eg, BCBS, Aetna). Patients insured through Medicare, Medicaid, and TRICARE are not eligible
  • Be a resident of the United States or Puerto Rico
  • Have a valid prescription for Jakafi for an FDA-approved treatment (see indications and usage below)

How do I enroll for copay/coinsurance assistance through IncyteCARES?

To enroll:
  • Receive your Jakafi prescription from your healthcare professional
  • Call IncyteCARES at 1-855-4-Jakafi (1-855-452-5234)
  • Answer a few questions so IncyteCARES can assess your eligibility, and if eligible receive and/or activate your copay/coinsurance card
  • You or IncyteCARES contacts the pharmacy providing your Jakafi to give them your copay/coinsurance Group, Bin, and Member numbers to receive copay/coinsurance assistance
  • Read program terms and conditions here
Pharmacies: call 1-855-799-1295 to activate card.

How long does it take to find out if I’m approved for the IncyteCARES Copay/Coinsurance Assistance Program?

Once you have contacted IncyteCARES at 1-855-4-Jakafi (1-855-452-5234), answered a few questions, and eligibility is determined, you will receive a membership number immediately. You or IncyteCARES will then be able to reach out to your specialty pharmacy to provide them with your copay/coinsurance information so that they can apply the copay/coinsurance amount due for your prescription.

Patient Assistance Program (PAP) FAQs

How long does it take to find out if a patient has been approved for the PAP?

Conditional approval for the PAP is provided between 1 and 2 business days after completed enrollment form submission.

What are acceptable documents to validate income for the PAP?

Documentation submitted to IncyteCARES for conditionally approved patients should reflect current household income. Acceptable documents to provide for current income include the latest 1040 tax returns or W2s, or 1 month of recent pay stubs.

How does conditional approval work for the PAP?

After an enrollment form is deemed complete, IncyteCARES will review the financial information (household size and current annual income) and determine whether to approve a patient for the PAP for up to 90 days while income documentation is either being faxed or mailed to IncyteCARES.

What are the eligibility criteria for the PAP through IncyteCARES?

Patients who don’t have prescription drug coverage or are rendered uninsured and who are US or Puerto Rico residents with a valid Jakafi prescription for an FDA-approved indication and currently have an income less than $125,000 or 600% of the Federal Poverty Level, whichever is greater, may be eligible for the PAP for Jakafi.

Indications and Usage

Jakafi is a prescription medicine used to treat people with polycythemia vera who have already taken a medicine called hydroxyurea and it did not work well enough or they could not tolerate it.

Jakafi is also used to treat certain types of myelofibrosis.

Important Safety Information

Jakafi can cause serious side effects, including:

Low blood counts: Jakafi® (ruxolitinib) may cause your platelet, red blood cell, or white blood cell counts to be lowered. If you develop bleeding, stop taking Jakafi and call your healthcare provider. Your healthcare provider will perform blood tests to check your blood counts before you start Jakafi and regularly during your treatment. Your healthcare provider may change your dose of Jakafi or stop your treatment based on the results of your blood tests. Tell your healthcare provider right away if you develop or have worsening symptoms such as unusual bleeding, bruising, tiredness, shortness of breath, or a fever.

Infection: You may be at risk for developing a serious infection during treatment with Jakafi. Tell your healthcare provider if you develop any of the following symptoms of infection: chills, nausea, vomiting, aches, weakness, fever, painful skin rash or blisters.

Skin cancers: Some people who take Jakafi have developed certain types of non-melanoma skin cancers. Tell your healthcare provider if you develop any new or changing skin lesions.

Increases in cholesterol: You may have changes in your blood cholesterol levels. Your healthcare provider will do blood tests to check your cholesterol levels during your treatment with Jakafi.

The most common side effects of Jakafi include: low platelet count, low red blood cell counts, bruising, dizziness, headache.

These are not all the possible side effects of Jakafi. Ask your pharmacist or healthcare provider for more information. Tell your healthcare provider about any side effect that bothers you or that does not go away.

Before taking Jakafi, tell your healthcare provider about: all the medications, vitamins, and herbal supplements you are taking and all your medical conditions, including if you have an infection, have or had tuberculosis (TB) or have been in close contact with someone who has TB, have or had hepatitis B, have or had liver or kidney problems, are on dialysis, had skin cancer, or have any other medical condition. Take Jakafi exactly as your healthcare provider tells you. Do not change your dose or stop taking Jakafi without first talking to your healthcare provider. Do not drink grapefruit juice while on Jakafi.

Women should not take Jakafi while pregnant or planning to become pregnant, or if breast-feeding.

Please see Full Prescribing Information, which includes a more complete discussion of the risks associated with Jakafi.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

You may also report side effects to Incyte Medical Information at 1-855-463-3463.