Medication Cost Support

If you need help with your SIMPONI^® medication costs, speak with a SimponiOne^® Care Coordinator. Whether you have commercial or private health insurance, government-funded insurance (such as Medicare or Medicaid), or no coverage at all, we can help explain your medication insurance coverage and potential out-of-pocket medication costs and identify resources that may help make SIMPONI^® medication more affordable.

If you have:	A SimponiOne^® Care Coordinator can help:
Commercial or Private Health Insurance	Determine your eligibility for SimponiOne^® Cost Support. If eligible, you may receive up to a full year of instant savings on your SIMPONI^® out-of-pocket medication costs. For eligibility, requirements, and restrictions, click here to get the SimponiOne^® Cost Support Guide.^* Requires Adobe^® Reader^®. Click here to download. A SimponiOne^® Care Coordinator will contact you before your benefit period ends to review your continued eligibility for the next 12 months of benefits. If eligible, you’ll continue to pay $5 for each SIMPONI^® injection. To receive instant savings on your SIMPONI^® medication cost, be sure to present your SimponiOne^® Cost Support Instant Savings Card at your pharmacy each time you fill your prescription for SIMPONI^®. If your pharmacy is unable to process your Instant Savings Card, or your physician chooses to obtain SIMPONI^® for you, you can complete, sign and return the rebate form, with required proof of purchase, to receive your cost support. Click here to get the rebate form.^ *Requires Adobe^® Reader^®. Click here to download.
Government-funded Insurance such as Medicare, Medicaid or need supplemental assistance	Direct you to independent foundations that may be able to help if you have government-funded insurance, or have exhausted your commercial or private health insurance prescription benefit, and need help affording your SIMPONI^® medication.
No Health Insurance	Direct you to Patient Assistance Foundation Johnson & Johnson Patient Assistance Foundation, Inc. (JJPAF) is committed to providing access to uninsured individuals that lack the financial resources to pay for their medicines. If you are uninsured and unable to pay for your SIMPONI^® medicine, please contact a JJPAF program specialist at 800-652-6227 or visit the Foundation website at JJPAF.org to see if you might qualify for assistance.

If you have:

A SimponiOne^® Care Coordinator can help:

Commercial or Private Health Insurance

Determine your eligibility for SimponiOne^® Cost Support.

If eligible, you may receive up to a full year of instant savings on your SIMPONI^® out-of-pocket medication costs.

Medication Cost Support Chart

For eligibility, requirements, and restrictions, click here to get the SimponiOne^® Cost Support Guide.^*

*Requires Adobe^® Reader^®. Click here to download.

A SimponiOne^® Care Coordinator will contact you before your benefit period ends to review your continued eligibility for the next 12 months of benefits. If eligible, you’ll continue to pay $5 for each SIMPONI^® injection.

To receive instant savings on your SIMPONI^® medication cost, be sure to present your SimponiOne^® Cost Support Instant Savings Card at your pharmacy each time you fill your prescription for SIMPONI^®.

If your pharmacy is unable to process your Instant Savings Card, or your physician chooses to obtain SIMPONI^® for you, you can complete, sign and return the rebate form, with required proof of purchase, to receive your cost support. Click here to get the rebate form.^*

*Requires Adobe^® Reader^®. Click here to download.

Government-funded Insurance

such as Medicare, Medicaid or need supplemental assistance

Direct you to independent foundations that may be able to help if you have government-funded insurance, or have exhausted your commercial or private health insurance prescription benefit, and need help affording your SIMPONI^® medication.

No Health Insurance

Direct you to Patient Assistance Foundation
Johnson & Johnson Patient Assistance Foundation, Inc. (JJPAF) is committed to providing access to uninsured individuals that lack the financial resources to pay for their medicines. If you are uninsured and unable to pay for your SIMPONI^® medicine, please contact a JJPAF program specialist at 800-652-6227 or visit the Foundation website at JJPAF.org to see if you might qualify for assistance.

Do you need additional assistance?
To determine your eligibility for other assistance programs that may be able to help with SIMPONI^® medication costs, visit JanssenPrescriptionAssistance.com/Simponi.

Talk with a SimponiOne^® Support Care Coordinator

877-MY SIMPONI (877-697-4676)
Mon – Fri, 8:00 AM – 8:00 PM E.T.

¿Habla español?
SimponiOne^® offers Spanish-speaking Care Coordinators.
SimponiOne^® ofrece Coordinadores de Atención de habla hispana.

Please read the Important Safety Information about SIMPONI^® below, and the Medication Guide, and talk with your doctor.

Next: Injection Support

SIMPONI^® is a once-monthly self-injectable biologic treatment for adults with:

moderate to severe rheumatoid arthritis (RA), with the medicine methotrexate
active psoriatic arthritis, alone or with the medicine methotrexate
active ankylosing spondylitis

Methotrexate is used as directed.

Once you and your doctor are comfortable with the self-injection process, you will inject SIMPONI^® under the skin, just once a month.

SIMPONI^® is used in adults with moderate to severe active ulcerative colitis (UC) when certain other UC medicines have not worked well enough or cannot be tolerated, or if it is necessary to continue taking steroid medicines:

to begin helping some of your symptoms
in people who respond to SIMPONI^®, to get their UC under control (induce remission) and keep UC under control
(sustain remission)
to begin to improve the way the lining of your large intestine looks to your doctor during colonoscopy

SIMPONI^® is a self-injectable biologic treatment given every 4 weeks after
2 starter doses.

Once you and your doctor are comfortable with the self-injection process, you will inject SIMPONI^® under the skin.

IMPORTANT SAFETY INFORMATION

SIMPONI^® (golimumab) is a prescription medicine. SIMPONI^® can lower your ability to fight infections. There are reports of serious infections caused by bacteria, fungi, or viruses that have spread throughout the body, including tuberculosis (TB) and histoplasmosis. Some of these infections have been fatal. Your doctor will test you for TB before starting SIMPONI^® and will monitor you for signs of TB during treatment. Tell your doctor if you have been in close contact with people with TB. Tell your doctor if you have been in a region (such as the Ohio and Mississippi River Valleys and the Southwest) where certain fungal infections like histoplasmosis or coccidioidomycosis are common.

You should not start SIMPONI^® if you have any kind of infection. Tell your doctor if you are prone to or have a history of infections or have diabetes, HIV or a weak immune system. You should also tell your doctor if you are currently being treated for an infection or if you have or develop any signs of an infection such as:

fever, sweat, or chills
muscle aches
cough
shortness of breath
blood in phlegm

weight loss
warm, red, or painful skin or sores on your body
diarrhea or stomach pain
burning when you urinate or urinate more than normal
feel very tired

Unusual cancers have been reported in children and teenage patients taking TNF-blocker medicines. For children and adults taking TNF blockers, including SIMPONI^®, the chances for getting lymphoma or other cancers may increase. Hepatosplenic T-cell lymphoma, a rare and fatal lymphoma, has occurred mostly in teenage or young adult males with Crohn’s disease or ulcerative colitis who were taking other TNF blockers with azathioprine or 6-mercaptopurine. You should tell your doctor if you have had or develop lymphoma or other cancers.

Some people treated with SIMPONI^® have developed certain kinds of skin cancer. If any changes in the appearance of your skin or growths on your skin occur during or after your treatment with SIMPONI^®, tell your doctor.

Tell your doctor about all the medications you take including ORENCIA (abatacept), KINERET (anakinra), ACTEMRA (tocilizumab), RITUXAN (rituximab), or another TNF blocker, or if you are scheduled to or recently received a vaccine. People taking SIMPONI^® should not receive live vaccines.

Reactivation of hepatitis B virus has been reported in patients who are carriers of this virus and are taking TNF-blocker medicines, such as SIMPONI^®. Some of these cases have been fatal. Your doctor should do blood tests before and after you start treatment with SIMPONI^®. Tell your doctor if you know or think you may be a carrier of hepatitis B virus or if you experience signs of hepatitis B infection, such as:

feel very tired
dark urine
skin or eyes look yellow
little or no appetite
vomiting
muscle aches

clay-colored bowel movements
fevers
chills
stomach discomfort
skin rash

Heart failure can occur or get worse in people who use TNF blockers, including SIMPONI^®. Your doctor will closely monitor you if you have heart failure. Tell your doctor right away if you get new or worsening symptoms of heart failure like shortness of breath or swelling of your lower legs or feet.

Rarely, people using TNF blockers, including SIMPONI^®, can have nervous system problems such as multiple sclerosis or Guillain-Barré syndrome. Tell your doctor right away if you have symptoms like vision changes, weakness in your arms or legs, or numbness or tingling in any part of your body.

Serious liver problems can happen in people using TNF blockers, including SIMPONI^®. Contact your doctor immediately if you develop symptoms such as feeling very tired, skin or eyes look yellow, poor appetite or vomiting, or pain on the right side of your stomach.

Low blood counts have been seen with people using TNF blockers, including SIMPONI^®. If this occurs, your body may not make enough blood cells to help fight infections or help stop bleeding. Your doctor will check your blood counts before and during treatment. Tell your doctor if you have signs such as fever, bruising, bleeding easily, or paleness.

Rarely, people using TNF blockers have developed lupus-like symptoms. Tell your doctor if you have any symptoms such as a rash on your cheeks or other parts of the body, sensitivity to the sun, new joint or muscle pain, becoming very tired, chest pain or shortness of breath, swelling of the feet, ankles, and/or legs.

New or worse psoriasis symptoms may occur. Tell your doctor if you develop red scaly patches or raised bumps that are filled with pus.

Tell your doctor if you are pregnant, planning to become pregnant or are breastfeeding or have a baby and were using SIMPONI^® during pregnancy. Tell your baby’s doctor before your baby receives any vaccine because of an increased risk of infection for up to 6 months after birth.

Tell your doctor if you are allergic to rubber or latex. The needle cover contains dry natural rubber.

Tell your doctor if you have any symptoms of an allergic reaction while taking SIMPONI^® such as hives, swollen face, breathing trouble, or chest pain. Some reactions can be serious and life-threatening.

Common side effects of SIMPONI^® include: upper respiratory tract infection, reaction at site of injection, and viral infections.

Please read the Full Prescribing Information and Medication Guide for SIMPONI^® and discuss any questions you have with your doctor.

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.

This site is published by Janssen Biotech, Inc., which is solely responsible for its contents. The material on this site is intended only as informational or as an educational aid and is not intended to be taken as medical advice. The ultimate responsibility for patient care resides with a healthcare professional.

The information on this site is intended for the use of patients and caregivers in the United States and Puerto Rico only. Laws, regulatory requirements, and medical practices for pharmaceutical products vary from country to country. The Prescribing Information included here may not be appropriate for use outside the United States and Puerto Rico.

Last updated May 16, 2013