INVEGA SUSTENNA® Is Covered for the Majority of Your Patients and May Be Available at Out-of-Pocket Costs Similar to Generics*
Government Coverage Options
Medicare Low-Income Subsidy (LIS)
Full Subsidy-Full Dual Eligible Individuals INVEGA SUSTENNA® patients pay
$0 to $9.85 per dose1†
Through the Medicare Part D Program
Medicaid fee-for-service patients may pay
less than $8 per dose2‡
*For Medicaid, dual-eligible, and Low-Income Subsidy–eligible patients.
†See full eligibility requirements for the low-income subsidy 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 SUSTENNA®, INVEGA TRINZA®, 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.
Janssen CarePath Savings Program can help eligible patientspay $10 per dose
with an $8,000 maximum program benefit per calendar year or 12 doses, whichever comes first§
§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 injection. See full eligibility requirements at InvegaSustenna.JanssenCarePathSavings.com.
Online Enrollment of Patients in the Savings Program by You, the Pharmacy, the Patient, or the Caregiver
Providers and pharmacies can use Express Enrollment for the Savings Program at JanssenCarePathPortal.com/express
Comprehensive Provider Portal for the Savings Program and more at JanssenCarePathPortal.com
Patients and caregivers can enroll at MyJanssenCarePath.com/express
Janssen CarePath Is Your One Source for Access, Affordability, and Treatment Support for Your Patients
Janssen CarePath helps verify insurance coverage for your patients, provides reimbursement information, helps find financial assistance options for eligible patients, and provides ongoing support to help patients start and stay on prescribed INVEGA SUSTENNA®.
References: 1. Centers for Medicare & Medicaid Services. Announcement of Calendar Year (CY) 2022 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies: table V-2. January 15, 2021. Accessed September 14, 2022. https://www.cms.gov/files/document/2022-announcement.pdf 2. Medicaid and CHIP Payment and Access Commission. Cost Sharing and Premiums: Benefits. Accessed September 14, 2022. https://www.macpac.gov/subtopic/cost-sharing-and-premiums/