Education and resources
designed with
your patients in mind

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For your office

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Enrollment and Prescription Form

Enrollment and Prescription Form

This form is the first step to understanding your patient’s insurance coverage and enrolling the patient in TREMFYA withMe.

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TREMFYA® Prior Authorization Checklist

TREMFYA® Prior Authorization Checklist

Reminders and tips when completing prior authorizations for your patients.

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Sample Letter of Exception

Sample Letter of Exception

To document the request for a payer to cover a nonformulary product or when step therapy through other treatments is required.

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Sample Letter of Medical Necessity

Sample Letter of Medical Necessity

To document rationale as to why a payer’s formulary products may not be clinically appropriate for a patient. May also be used when a payer does not have a known coverage policy in effect.

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TREMFYA withMe Delay and Denial Support

TREMFYA withMe Delay and Denial Support

A resource that provides a detailed guide on how to get support in the event of a coverage delay or denial for your commercially insured patients.

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Sample Letter of Appeal

Sample Letter of Appeal

To document and request a payer review a denied coverage determination for TREMFYA®, such as prior authorization or exception request denials.

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Business Associate Agreement

Business Associate Agreement

Complete this Business Associate Agreement (BAA) one time only to allow you to request verification of patients’ insurance benefits without requiring individual Patient Authorization.

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Patient Authorization

Patient Authorization

If no BAA is on file, you must secure Patient Authorization for each patient. Use this form or have the patient complete the Patient Authorization Form (PAF). TREMFYA withMe cannot accept any patient without an executed BAA or Patient Authorization on file.

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TREMFYA withMe Specialty Pharmacy List

TREMFYA withMe Specialty Pharmacy List

Quick reference guide to Specialty Pharmacy partners within the TREMFYA withMe program.

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Access & Affordability Resources

Access & Affordability Resources

Tools & resources that help navigate payer processes and support getting your patients started on TREMFYA®.

For your patients

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Patient Brochure

Patient Brochure

A patient-friendly overview of product information for TREMFYA® in active PsA.

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TREMFYA withMe

TREMFYA withMe

TREMFYA withMe can help verify insurance coverage for your patients, provide reimbursement information, find financial assistance options for eligible patients, and provide ongoing support to help patients start and stay on TREMFYA®.

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TREMFYA withMe Patient Brochure

TREMFYA withMe Patient Brochure

A resource to help explain the benefits of TREMFYA withMe to your patients.

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TREMFYA withMe Savings Program

TREMFYA withMe Savings Program

Eligible commercially insured patients pay $5 per injection. Maximum program benefit per calendar year shall apply. Terms expire at the end of each calendar year and may change. See program requirements at TremfyawithMeSavings.com.

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Patient Affordability Options

Patient Affordability Options

Discover options that may help make TREMFYA® more affordable for your patients. Download this resource to help your patients learn about cost support options.

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TREMFYA withMe Delay and Denial Support

TREMFYA withMe Delay and Denial Support

A resource that provides a detailed guide on how to get support in the event of a coverage delay or denial for your commercially insured patients.

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Full Prescribing Information and Instructions for Use in Spanish

Full Prescribing Information and Instructions for Use in Spanish

For Spanish-speaking patients, this document includes the full Prescribing Information, Medication Guide, and Instructions for Use (IFU).

TREMFYA withMe is limited to education for patients about TREMFYA®, its administration, and/or their disease, and is not intended to provide medical advice, replace a treatment plan from the patient’s doctor or nurse, or provide case management services.

Injection demonstration
videos

Watch these easy-to-follow injection demonstration videos for TREMFYA®.

The injection demonstration videos are not meant to replace the IFU that is supplied with TREMFYA®. Instruct patients to read the IFU before using their TREMFYA® prefilled syringe or One-Press injector and each time they get a refill. Please see the full Instructions for Use (IFU) for TREMFYA®.

TREMFYA® is intended for use under the guidance and supervision of a physician. Patients may self-inject with TREMFYA® after physician approval and proper training.

One-Press injector demonstration video

Prefilled syringe demonstration video

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Have a discussion with a Janssen representative

Talk with a Janssen representative

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Contact your local sales repContact your local representative
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