Care Coordinators can:
- Review your health plan benefits to help navigate ways to make OPSUMIT more affordable
- Get you started with PAHCompanion.com* for one-on-one educational conversations and support
- Work with you and your specialty pharmacy to streamline J&J medicine delivery
*PAH Companion withMe is limited to education about your J&J PAH therapy, its administration, and/or PAH. It is not intended to provide medical advice, replace a treatment plan you receive from your healthcare team, or serve as a reason for you to start or stay on treatment.
Getting Started with OPSUMIT
OPSUMIT is delivered by a specialty pharmacy—it's not something that's kept in stock at your local retail pharmacy. The following is a typical process when starting out with OPSUMIT, though your experience may vary.
1Prescription
Your doctor selects OPSUMIT as your new treatment.
- Your healthcare team completes all the forms necessary to start you on the J&J medicine. For OPSUMIT, these forms include your prescription and, for females, enrollment in a program to make sure you use effective birth control during OPSUMIT treatment and for 1 month after treatment discontinuation
2Insurance verification
The insurance company may ask your healthcare provider for additional information before they pay for your medicine.
- A Care Coordinator can help with this process by gathering additional information from your healthcare team
3Delivery of medicine
OPSUMIT is shipped to you by a specialty pharmacy.
- A Care Coordinator will help you connect with a specialty pharmacy that delivers OPSUMIT in your area
- Each month, the specialty pharmacy will call you to confirm details of the delivery, make sure you've completed a pregnancy test if required, and arrange your refill
- The shipment is usually quick, but the process leading up to your first delivery could take more than 2 weeks
- Before shipping, the specialty pharmacy will call you to confirm some details, including the shipment date and verification that you've completed a pregnancy test (if required). Be sure to answer, or call the specialty pharmacy back if they leave a message
Remember, the call from your specialty pharmacy may come from a phone number that you don't know. If you miss the call, it's important that you call back.
Your Care Coordinator may need additional information from you at the start of treatment
When you speak with a Care Coordinator, they may ask for additional information, including:
- Details of your healthcare plan, including the name and contact information for the insurance company and your policy number
- The name and contact information of your prescribing doctor (including the fax number)
- Further details from your healthcare team, if your initial claim is denied
If you change insurance plans or healthcare providers, speak with your healthcare team and a Care Coordinator in a timely manner to make sure you can continue your treatment.
Contact a Care Coordinator with questions at 866-228-3546, Monday–Friday, .
PAHCompanion.com
People living with PAH and those that support them can obtain free resources at pahcompanion.com. Gain 24/7 access to information like tips to manage your PAH and connections to PAH support groups–all in one place.
