INVEGA SUSTENNA®
may be just as affordable as generic oral options, with less than a $3 difference in monthly out-of-pocket cost2,3†‡§||
Affordability for patients may improve when they transition to LAIs with longer dosing intervals1*
For adults with schizophrenia and Medicaid or Medicare Part D Low-Income Subsidy (LIS) coverage
INVEGA TRINZA®
may be just as affordable as generic oral options, with less than a $1 difference in monthly out-of-pocket cost2,3†‡||
INVEGA HAFYERA®
may cost no more than $11.204¶#
This information is not a promise of coverage or payment. It is not intended to give reimbursement advice or increase reimbursement by any payer. Legal requirements and plan information can be updated frequently. Contact the plan for more information about current coverage, reimbursement policies, restrictions, or requirements that may apply.
LAI=long-acting injectable.
*This analysis was specific to government payers only.1
†All dual-eligible Medicare Part D beneficiaries (ie, those with Medicare and Medicaid coverage) also have LIS status. However, not all full LIS patients are dual-eligible.
‡Inclusive of Medicare Part D full LIS in the pre-initial coverage limit (ICL) and ICL phases.
§The 2 starting doses of INVEGA SUSTENNA® have been factored into the mean and median monthly patient out-of-pocket cost calculations.
||As demonstrated in 2 separate studies determining mean Medicaid out-of-pocket cost or median Medicare out-of-pocket cost. Medicaid benefit may vary by state.
¶See full eligibility requirements for the LIS for Medicare Prescription Drug Coverage: https://www.cms.gov/medicare/eligibility-and-enrollment/lowincsubmedicareprescov/eligibilityforlowincomesubsidy
#Above 150% of the Federal Poverty Level, patients may pay up to 20% of the amount the Medicaid agency pays. Medicaid Fee-for-Service is a state-specific program. Coverage for INVEGA HAFYERA® may depend on the indication as well as other factors. As this information varies by state, it is important to contact the state agency directly or consult its website to obtain product-specific coverage and other information.
Commercial
insurance
Janssen CarePath provides resources to help adult patients living with schizophrenia start and stay on therapy.
Janssen CarePath provides resources to help adult patients living with schizophrenia start and stay on therapy.
Support for patients using commercial or private insurance to pay for medication
Eligible patients using commercial or private insurance to pay for their medication can save on their out-of-pocket costs for INVEGA SUSTENNA®, INVEGA TRINZA®, and INVEGA HAFYERA®. Depending on the patient’s health insurance plan, savings may apply toward co-pay, co-insurance, or deductible.
Eligible patients pay $10 per dose with an $8,000 maximum program benefit per calendar year or 13 doses, whichever comes first, for INVEGA SUSTENNA®
Eligible patients pay $10 per dose with an $8,000 maximum program benefit per calendar year or 4 doses, whichever comes first, for INVEGA TRINZA®
Eligible patients pay $10 per dose with an $8,000 maximum program benefit per calendar year or 2 doses, whichever comes first, for INVEGA HAFYERA®
Not valid for patients using Medicare, Medicaid, or other government-funded programs to pay for their medications. Terms expire at the end of each calendar year and may change. There is no income requirement. Program does not cover the cost to give patients their injections. See program requirements 
Online enrollment of patients in the Savings Program by you, the pharmacy, patient, or caregiver
Providers and pharmacies can use Express Enrollment for Savings Program at:
JanssenCarePathPortal.com/express
Patients and caregivers can enroll at:
MyJanssenCarePath.com/express
References: 1. Data on file. Janssen Pharmaceuticals, Inc. 2. Li P, Benson C, Zhi Geng Z, et al. Out-of-pocket costs for long-acting injectable and oral antipsychotics among full Low-Income Subsidy (LIS) Medicare beneficiaries with schizophrenia. Presented at: Psych Congress Elevate; June 3-5, 2022; Las Vegas, NV. 3. Lin D, Pilon D, Benson C, et al. PMH7: Assessment of patient out-of-pocket costs for antipsychotic treatments among Medicaid beneficiaries with schizophrenia. Presented at: ISPOR 2021; May 17-20, 2021; Virtual. 4. Announcement of Calendar Year (CY) 2024 Medicare Advantage (MA) capitation rates and Part C and Part D payment policies. Centers for Medicare & Medicaid Services. March 31, 2023. Accessed October 18, 2023. https://www.cms.gov/files/document/2024-announcement-pdf.pdf