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Crohn’s Disease (CD): Access & Support | STELARA® (ustekinumab) HCP

STELARA withMe is all about dedicated support

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Nurse Navigator

A trained professional is available to patients to offer support and answer questions about STELARA®, including self-injection training, scheduling a one-time IV infusion, coverage, and options for saving on treatment.

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Reimbursement Support

Your Field Reimbursement and Access Specialist (FRAS) provides in-office educational support and additional assistance to help patients have a positive experience throughout their STELARA® treatment journey.

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Infusion Services

Infusion Services is intended to help patients transition from their single infusion to injection. Infusion Services utilizes Infusion Services Providers (ISPs) to coordinate patient continuity of care and support the overall patient experience by leveraging existing infrastructure and clinical experience.

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Access and Affordability Support

We can verify insurance coverage, provide reimbursement information, help find financial assistance options, and offer ongoing support, so you can help patients start and stay on STELARA®.

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Specialty Pharmacy Enhanced Services

Specialty pharmacies provide enhanced product fulfillment and patient support services.

STELARA withMe is limited to education for patients about STELARA®, 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.

Enhanced services provided by each specialty pharmacy may vary.

Janssen Biotech, Inc., does not endorse the use of any pharmacies in particular. The information provided represents no statement, promise, or guarantee of Janssen Biotech, Inc., concerning levels of reimbursement, payment, or charge. Please consult specific payer organizations with regard to local or actual coverage, reimbursement policies, and determination processes.

Access support to help navigate payer processes

STELARA withMe helps verify insurance coverage for your patients taking STELARA® and provides reimbursement information.

Provider Portal

Available digital resources include:

  • eBenefits investigations
  • ePrior authorization support and status monitoring
    • Payer-specific Prior Authorization (PA) forms delivered in Portal
  • eCreation of medical necessity and exceptions letters
  • eRequest for exceptions and appeals information
  • Online coding and billing information
  • Online Live Chat feature to answer questions
  • Online Secure Messaging to ask a question, request a status update, or send missing information related to an existing case
  • Triage to specialty pharmacy providers, if needed

Complete and submit the Benefits Investigation and Prescription Enrollment Form

Learn more about insurance coverage, reimbursement, and patient affordability options.
Log in to the Provider Portal:

Benefits Investigation and Prescription Enrollment Form

Call a STELARA withMe Nurse Navigator at 844-4withMe (494-8463) Monday through Friday, 8:00 AM to 8:00 PM ET.

It’s easy to sign your patient up for the STELARA withMe Program. To get started, have your patient complete the Patient Authorization Form (PDF download) and submit it with the Enrollment and Prescription Form (PDF download)—or submit online at www.stelarawithme.com/HCP.

Log in to the Provider Portal at JanssenCarePathPortal.com where you can request and review benefits investigations and view Savings Program transactions as requested by the patient. Visit JanssenCarePathPortal.com.

Information about your patient’s insurance coverage, cost support options, and treatment support is given by service providers for STELARA withMe via Janssen CarePath. The information you get does not require you or your patient to use any Janssen product. Because the information we give you comes from outside sources, STELARA withMe cannot promise the information will be complete. STELARA withMe cost support is not for patients in the Johnson & Johnson Patient Assistance Foundation.

Support for patients using commercial or private insurance

STELARA® IV INDUCTION

Verify medical benefit coverage
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If YES

and Patient is Using Commercial or Private Insurance.

Enroll Patient in the STELARA withMe Savings Program.

STELARA withMe Savings Program will help eligible patients save on their out-of-pocket medication costs for STELARA®. Eligible patients pay $5 per dose. Maximum program benefit per calendar year shall apply. Terms expire at the end of each calendar year and may change. Program does not cover the cost to give patients their treatment.

See full eligibility requirements

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If NO

STELARA withMe Can Provide Information on the Exceptions and Appeals Process

 

STELARA® SUBQ MAINTENANCE

Verify pharmacy benefit coverage
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If YES

and Patient Is Using Commercial or Private Insurance.

Enroll Patient in the STELARA withMe Savings Program.

STELARA withMe Savings Program will help eligible patients save on their out-of-pocket medication costs for STELARA®. Eligible patients pay $5 per dose. Maximum program benefit per calendar year shall apply. Terms expire at the end of each calendar year and may change. Program does not cover the cost to give patients their treatment.

See full eligibility requirements

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If NO

STELARA withMe Can Provide Information on the Exceptions and Appeals Process

Delay and Denial Support
When commercial insurance coverage is delayed >5 business days or denied, STELARA withMe offers eligible patients subcutaneous STELARA® at no cost until their commercial insurance covers the medication. See program requirements at JanssenCarePath.com/Stelara/Janssen-Link

 

For patients needing additional assistance: View affordability options here.

Treatment support for your patients

Enroll your patients in STELARA withMe

STELARA withMe provides a range of dedicated support and resources to help make it easier for patients as they begin, and continue, their STELARA® treatment journey.

Nurse Navigator

A trained professional is available to patients to offer support and answer questions about STELARA®, including self-injection training, scheduling a one-time IV infusion, coverage, and options for saving on treatment.

Treatment Support

Your Nurse Navigator will help your patient schedule a one-time IV infusion, provide self-injection training, and offer support to help them stay on track throughout their treatment journey.

Reimbursement Support

Patients can get help with verifying insurance coverage, understanding how to fill prescriptions, and looking for options to make treatment more affordable.

 

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If your practice has infusion capabilities
If your practice refers out for infusion
  • Search on www.2infuse.com to locate an infusion site convenient to your patient’s home or office.
  • Refer patient to their preferred location for infusion.
  • Confirm with the infusion site and patient that infusion has taken place.
 
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When your patient is ready for maintenance treatment
  • STELARA withMe will send the prescription for first and subsequent injections to the Specialty Pharmacy of your choice.
  • Specialty Pharmacy sends the first STELARA® subQ dose to your office or directly to your patient.
  • Patient receives the first STELARA® subQ injection in your office or self-administers at home (office required to train first; Nurse Navigator training would be supplemental).
  • Specialty Pharmacy sends subsequent maintenance doses directly to patient as prescribed.
 
STELARA® Dosing and Administration Guide

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A guide containing details on how to prepare and administer STELARA® for both IV infusion and subQ maintenance dosing.