INVEGA SUSTENNA® is approved for the treatment of schizoaffective disorder
Outpatient Sample Program
The Outpatient Sample Program is designed to help you receive samples of the product free of charge, to help initiate patients on INVEGA SUSTENNA®. Starting doses will be mailed directly to your participating facility.
If you have questions, please contact our Customer Service Center at 1-855-463-1912, Monday through Friday, between 8 am and 8 pm ET.
I recognize that this is a product sample submitted for the needs of my patients and will not be sold, traded, bartered, returned for credit, or submitted for third-party reimbursement.
Inpatient Hospital Pharmacy Free Trial
The INVEGA SUSTENNA® Inpatient Hospital Pharmacy Free Trial Program is available only to inpatient hospital pharmacies that are unable to accept PDMA samples. Janssen Pharmaceuticals, Inc., is offering patients determined to be appropriate for a trial of INVEGA SUSTENNA® the opportunity to receive up to 2 free trial units per calendar year per patient, subject to quantity limits. To receive free trial units for patients, annual enrollment and adherence to program rules are required.
Please see below for an overview of the program rules for the INVEGA SUSTENNA® Inpatient Hospital Pharmacy Free Trial Program. In order to receive free trial units for your patients, you must agree and adhere to all program rules, which can be found at inpatientfreetrialprogram.com:
- The free trial product requested must be for an inpatient hospital licensed as a hospital under applicable state law
- The program is only available for an inpatient hospital that is unable to accept PDMA samples
- Retail pharmacies are not eligible for program participation
- There is no requirement for subsequent use of INVEGA SUSTENNA® for any patient receiving a free trial unit
- This program, as amended from time to time, will be available through December 31, 2018. Program available only in the United States and Puerto Rico*†
Annual enrollment is required with valid state license numbers from at least 1 of each of the following:
- (1)Inpatient hospital pharmacist
- (2)Inpatient hospital pharmacy
- (3)Inpatient hospital
- (4)Inpatient hospital prescriber
PATIENT AND PRESCRIBER QUANTITY LIMITS
- Pharmacists may order and receive for patients determined to be appropriate up to 2 free trial units per calendar year per patient
- Inpatient hospital pharmacies and inpatient hospitals must have the ability to track utilization of this program by each patient and establish adequate controls to ensure that product received under this program is appropriately segregated and tracked as if it were a PDMA sample
- Additional quantity limits may apply
PROHIBITION ON SEPARATE BILLING
- Free trial units are commercially labeled as trade product and not labeled as sample products
Do not separately bill the patient, the patient's insurance carrier, or the government for any
INVEGA SUSTENNA® dispensed as part of this program
- Free trial product received pursuant to this program may not be sold, traded, bartered, or returned for credit
- Orders requesting free trial units must be submitted within 30 days of the dispense date
PHARMACIST ACKNOWLEDGMENT OF RECEIPT (AOR)
- Failure to complete AOR(s) within a timely manner will result in suspension of the program
- Hospital, pharmacy, pharmacist, and prescriber information and the free trial disbursement(s) may be reported as required by state or federal law. Once reported, this information may be made available for public view
*Janssen Pharmaceuticals, Inc., may terminate the program prior to December 31, 2018, upon 60 days’ notice to all participating inpatient pharmacies, or upon less or no notice if there is a change in interpretation of federal or state laws supporting the continuation of the program.
†Shipments will not be processed Friday through Sunday or on holidays. These factors may result in a delay in shipment.
For questions about this program or if you no longer wish to participate, please call 1-855-463-1912, Monday through Friday, between 8 am and 8 pm ET.
Content area 1.2