Rybrevant (amivantamab)

Do You Qualify?

Income Limits (600% FPL)

Calculated based on 600% of the 2025 Federal Poverty Level, which is the standard threshold for Janssen oncology specialty products.

Based on 2025 HHS Federal Poverty Level guidelines.

# A Patient Guide to Getting Rybrevant (amivantamab) Through the Johnson & Johnson Patient Assistance Foundation, Inc. (JJPAF)

Prepared by RX Advantages

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

If you have been prescribed Rybrevant (amivantamab) and cannot afford it, you may be able to get it at no cost through the Johnson & Johnson Patient Assistance Foundation, Inc. (JJPAF). This program is designed for patients who lack adequate insurance coverage and meet income requirements. For a single-person household, the maximum annual income allowed is $90,360. To qualify, you must be uninsured, underinsured, or enrolled in Medicare Part D with demonstrated financial hardship — and you must have no other insurance coverage that applies to this medication. If you meet these criteria, this program may provide Rybrevant to you free of charge.

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About Rybrevant (amivantamab)

Rybrevant (amivantamab) is a prescription biologic medication manufactured by Janssen. It is approved by the U.S. Food and Drug Administration (FDA) to treat adults with non-small cell lung cancer (NSCLC) that has a specific genetic change called an EGFR exon 20 insertion mutation. Rybrevant works by targeting two proteins — the EGF receptor and the MET receptor — that play a role in cancer cell growth. As a biologic infusion therapy, Rybrevant is administered intravenously and carries a high list price that can reach tens of thousands of dollars per month without assistance. There are currently no FDA-approved biosimilar versions available, making patient assistance programs the primary path to affordable access for eligible patients.

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Income Eligibility: Full Breakdown

JJPAF uses income thresholds set at 600% of the 2025 Federal Poverty Level to determine eligibility for Rybrevant. The limits by household size are:

| Household Size | Maximum Annual Income |

|---|---|

| 1 person | $90,360 |

| 2 persons | $122,640 |

| 3 persons | $154,920 |

| 4 persons | $187,200 |

Your income is typically verified using your most recent U.S. federal income tax return, a W-2, or a 1099 form. If your tax documents are not available or do not reflect your current situation, some programs accept three months of recent pay stubs instead — check with JJPAF directly to confirm what they will accept.

Household size matters. If you are applying as a single person but support dependents, clarifying your household composition may affect which income threshold applies to you.

If your income is above the limit for your household size, you may not qualify for free medication through JJPAF. In that case, review the alternatives section below for other options, including the Rybrevant savings card program for insured patients.

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Insurance Requirements Explained

Your insurance status determines whether you qualify for JJPAF. Here is how each situation is handled:

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Step-by-Step: How to Apply

Follow these steps to apply for Rybrevant through JJPAF:

1. Confirm your eligibility. Review the income table and insurance requirements above. If you are unsure, call JJPAF at (800) 652-6227 before starting your application.

2. Gather your documents. You will need:

- A completed and signed application form (with both the Patient section and the Prescriber section filled out)

- Proof of income: your most recent U.S. income tax return, W-2, or 1099

- A copy of your Rybrevant prescription

- Copies of any insurance cards you currently hold (if applicable)

3. Get your prescriber involved. Your doctor or their office staff must complete and sign the Prescriber section of the application. Coordinate with your oncology office early, as this step can take time.

4. Choose your application method. You can apply:

- Online at https://www.jjpaf.org

- By phone at (800) 652-6227

- By fax at (888) 526-5168

- For additional support, visit https://www.rybrevant.com/support

5. Submit your complete application. Incomplete applications may cause delays. Make sure all signatures are in place and all documents are attached before submitting.

6. Wait for a decision. JJPAF typically processes applications within 2 to 5 business days after receiving a complete submission.

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What to Expect: Timeline and Delivery

Once JJPAF reviews your completed application, you can expect a decision within 2 to 5 business days. If approved, you will be notified — as will your prescriber's office. Rybrevant is shipped directly to your prescriber's office or infusion center, not to your home, since it is an intravenously administered biologic. You do not need to pick up or transport the medication yourself. Your care team will schedule your infusion appointments as usual.

Your approval is valid for approximately one year. Before that period ends, you will need to reauthorize your enrollment by submitting updated income documentation and a new application. Your prescriber's office may help coordinate this renewal.

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Alternatives If You Don't Qualify

If you do not qualify for JJPAF, you still have options:

1. Biosimilars: There are currently no FDA-approved biosimilar versions of Rybrevant available, so this is not an option at this time.

2. Manufacturer savings card: If you have commercial insurance, you may qualify for the Rybrevant Savings Program, which can reduce your out-of-pocket costs. Visit https://www.rybrevant.com/patient-support/savings-program to learn more.

3. State Pharmaceutical Assistance Programs (SPAPs): Many states offer programs that help cover prescription costs, especially for Medicare beneficiaries. Eligibility and benefits vary by state — contact your state health department or ask your social worker for guidance.

4. NeedyMeds.org: This free online database lists patient assistance programs, copay assistance, and disease-specific funds. Visit https://www.needymeds.org to search 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. Program terms may change — verify current requirements at [https://www.rybrevant.com/support](https://www.rybrevant.com/support) before applying.*

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