Opsumit (macitentan)

Do You Qualify?

Income Limits (500% FPL)

Calculated at 500% of FPL per 2025 guidelines which is standard for Janssen specialty products like Opsumit.

Based on 2025 HHS Federal Poverty Level guidelines.

# Free Opsumit (Macitentan) Through the Johnson & Johnson Patient Assistance Foundation: A Complete Guide

Who Qualifies for the Johnson & Johnson Patient Assistance Foundation, Inc. (JJPAF)?

If you have been prescribed Opsumit (macitentan) for pulmonary arterial hypertension and cannot afford the cost, the Johnson & Johnson Patient Assistance Foundation, Inc. (JJPAF) may be able to provide it at no charge. To qualify, a single-person household must earn no more than $75,300 per year. You must also meet specific insurance requirements — the program is designed for people who are uninsured, underinsured, or enrolled in Medicare Part D and meet financial and clinical criteria. If you fall into one of these categories and your income is within the program limits, you may qualify to receive Opsumit free of cost through this foundation.

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About Opsumit (Macitentan)

Opsumit (macitentan) is a prescription medication manufactured by Janssen (Actelion) and approved by the U.S. Food and Drug Administration (FDA) to treat pulmonary arterial hypertension (PAH), classified as WHO Group 1. It belongs to a drug class called endothelin receptor antagonists (ERAs), which work by blocking certain receptors involved in PAH. Opsumit is a specialty medication, and without insurance or assistance, its list price can exceed $10,000 or more per month, placing it out of reach for many patients. The JJPAF program exists specifically to help eligible patients access this medication without facing that financial barrier.

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Income Eligibility: Full Breakdown

The JJPAF uses income thresholds set at 500% of the Federal Poverty Level (FPL) based on 2025 guidelines. Your eligibility depends on both your household size and your total annual income.

| Household Size | Maximum Annual Income |

|---|---|

| 1 person | $75,300 |

| 2 persons | $102,200 |

| 3 persons | $129,100 |

| 4 persons | $156,000 |

Income is typically verified using your most recent U.S. federal income tax return, W-2 forms, or three months of recent pay stubs. The program generally looks at your prior year's reported income as the baseline.

If your income is above these limits, you may not qualify for free medication through JJPAF, but you are not out of options. Alternatives such as manufacturer savings cards, generic macitentan, or state pharmaceutical assistance programs may still provide meaningful savings. See the "Alternatives If You Don't Qualify" section below for more detail.

Household size is generally defined as those living in your home who are claimed as dependents or share household finances. If your household situation is unusual — such as living with a non-dependent family member — it is worth calling the program directly at (800) 652-6227 to ask how your household is counted before assuming you do not qualify.

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Insurance Requirements Explained

Your insurance status plays a key role in determining whether you qualify for JJPAF. Here is how the program handles different situations:

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Step-by-Step: How to Apply

Follow these steps to apply for free Opsumit through JJPAF:

1. Gather your documents. You will need: a valid, current prescription for Opsumit signed by your prescriber; proof of income (most recent federal tax return, W-2, or three months of pay stubs); and a completed application form with both the patient section and the prescriber section signed.

2. Download or request the application. Visit https://www.jjpaf.org to access the online application or download a printable form. You can also call (800) 652-6227 to request a paper application by mail.

3. Complete the patient section. Fill in your personal information, household size, income details, insurance status, and the medication you are requesting (Opsumit/macitentan).

4. Have your prescriber complete their section. Your doctor or their office staff must fill out and sign the prescriber portion, confirming your diagnosis of PAH (WHO Group 1) and your need for Opsumit.

5. Submit your application. You may apply online at https://www.jjpaf.org, fax your completed paperwork to (888) 526-5168, or mail it using the address provided on the application form. If you have questions during the process, call (800) 652-6227.

6. Watch for confirmation. After submission, the program will review your application and contact you or your prescriber with a decision.

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What to Expect: Timeline and Delivery

Once your completed application — including all required documents and the signed prescriber section — is submitted, processing typically takes 2 to 5 business days. Approval notification is generally sent to you and/or your prescriber's office. If approved, Opsumit will be shipped directly to your home address, so you do not need to pick it up at a pharmacy or prescriber's office.

Your assistance does not last indefinitely. Annual reauthorization is required, meaning you will need to reapply each year to confirm that you still meet the income and eligibility criteria. Watch for renewal notices from JJPAF to avoid a gap in your medication supply.

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Alternatives If You Don't Qualify

If you do not qualify for JJPAF assistance, several other options may help reduce or eliminate your cost for macitentan:

1. Generic macitentan: A generic version of macitentan is available and may cost significantly less than brand-name Opsumit. Ask your prescriber or pharmacist whether the generic is appropriate for you.

2. Manufacturer savings card (insured patients): If you have commercial insurance, you may be eligible for the Janssen CarePath savings program. Visit https://www.janssencarepath.com/patient/opsumit/cost-support to check your eligibility and enroll.

3. State Pharmaceutical Assistance Programs (SPAPs): Many states offer their own drug assistance programs, especially for residents who are older adults or have disabilities. Your state's health department website or your prescriber's office can help you find programs in your area.

4. NeedyMeds.org: This free, nonprofit database at https://www.needymeds.org allows you to search for patient assistance programs, disease-specific foundations, and discount options by drug name or condition — at no cost to you.

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*This guide is for informational purposes only and does not constitute medical or legal advice. Eligibility determinations are made solely by Janssen (Actelion). Program terms may change — verify current requirements at [https://www.opsumit.com/patient-support](https://www.opsumit.com/patient-support) before applying.*

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