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Estimated patient savings $600,000,000.00
Xyrem Patient Assistance Program


California-based Jazz Pharmaceuticals is a pharmaceutical company that seeks to fill the needs of the neurological and psychological field that they feel have not yet been met. Their main goal is to develop, acquire and license existing products, and then improve on those products by altering their chemical make up, thereby reducing the negative side-effects of the product. Working closely with patients, healthcare professionals, and groups advocating the right of patients, Jazz Pharmaceuticals is dedicated to the patient’s best interest.

Xyrem is a central nervous system depressant launched by Jazz Pharmaceuticals in July of 2002. Xyrem has been approved by the FDA to treat narcolepsy and excessive daytime sleepiness. Xyrem is administered orally. Because of the chance of abuse for this, the patient must arrange for refills with the company once a year.


Xyrem Patient Assistance Program a patient assistance program provided by Jazz Pharmaceuticals offers Xyrem 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 private or public health insurance.

- You must meet an undisclosed income guideline.

- You must be a citizen of the United States or its Territories

- You have insurance, but a co-payment of 25% or higher.

The medication must be sent to the physicians office.

Those eligible for Medicare Part D but not enrolled may still be eligible.

SOURCE: 2008 Poverty Chart
Family Size
Each Additional Family Member

What´s Next?

Fill out the program enrollment form located to your right. If you don't see an enrollment form available please call Jazz Pharmaceuticals, 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 Jazz Pharmaceuticals, 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 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 AAI Pharma Inc. program. Without their help millions of people will be without medication.

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