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Aciphex Patient Assistance Program

Summary

Johnson & Johnson Health Care Systems, Inc. is the parent company of Ortho-McNeil, Inc., creators of AcipHex. The goal of Orth-McNeil is to improve on the current state of patient care through the development of safe and effective treatments. PriCara, Unit of Ortho-McNeil, Inc., aims to provide new and improved solutions to health care professionals as no United State health care organization has done before.

AcipHex was launched by Johnson & Johnson Health Care Systems, Inc in 1999. It is used as a treatment for Gastroesophageal Reflux Disease, heartburn, ulcers, and Zollinger-Ellison syndrome. AcipHex is available in tablet form.

Eligibility

Johnson & Johnson Health Care Systems Inc., a division of the Johnson & Johnson company, manages the patient assistance program for PriCara, Unit of Ortho-McNeil, Inc..Their patient assistance program, Access 2 Wellness, offers up to a 1 year supply of Aciphex at no cost to those who are eligible for the program. Eligibility is based off of the following requirements:

  • You must not be covered by any private, public, or Medicare Part D health insurance and prescription coverage programs.
  • You must be a citizen of the United States or it's Territories.
  • You must be an outpatient currently under the care of a physician.
  • Your income must be less than or equal to 200% of the Federal Poverty Guideline for the size of your household (see chart below).

  • SOURCE: 2008 HHS Poverty Guidelines
    Persons in Family or Household 48 Contigous States and D.C. Alaska hawaii
    1 $10,400 $13,000 $11,960
    2 $14,000 $17,500 $16,100
    3 $17,600 $22,000 $20,240
    4 $21,200 $26,500 $24,380
    5 $24,800 $31,000 $28,520
    6 $28,400 $35,500 $32,660
    7 $32,000 $40,000 $36,800
    8 $35,600 $44,500 $40,940
    For each addtional person, add $3,600 $4,500 $4,140

    What’s Next?

    Fill out the program enrollment form located to your right. If you don’t see an enrollment form available please call Johnson & Johnson Health Care Systems, Inc program directly. After filling out the enrollment form please bring the form to your doctor for proper signatures and procedures. Do not forget a self stamped envelope for them to mail in your application to the program.

    Other Tips

  • If you have any questions please call the Johnson & Johnson Health Care Systems, Inc program directly
  • Fill out as much of the information on the enrollment form as possible. The more information you have pre-filled the easier the progrm is to enroll in
  • Write down the refill dates for your program and set a reminder here on PatientAssistance.com so that you don’t run out of medication.
  • Do not write messy on your forms as this will delay any response
  • Call and write thank you notes to Johnson & Johnson Health Care Systems, Inc program. Without their help millions of people will be without medication.



  • PAP Links:
    Create Account to View

    Company Website:
    Create Account to View

    Company Phone: Create Account to View
    Company Fax: Create Account to View
    Company Address:
    Create Account to View

    List of Medications:
    Aciphex Tablets 20mg (rabeprazole)

    Forms and other information are Copyright © Aciphex Patient Assistance Program