Call 1-855-727-6274 or Fax 1-844-727-6274

THIS SECTION IS FOR HEALTHCARE PROFESSIONALS (HCPs) ONLY
If you’re a patient and would like to apply for coverage, please check your eligibility.
If you qualify, please contact your HCP, who must apply on your behalf.
 Learn more about the application process.

OPAF Care Connect

If you’re an HCP, you can use the Otsuka Patient Assistance Foundation, Inc. (OPAF) portal on behalf of your patients to submit and track applications, download forms, access patient information, and more. Plus, the portal offers the fastest patient application processing time — you’ll receive your patient’s eligibility determination within 48 hours once all documentation has been submitted. If you do not have access to the portal, you can download the paper application below.

RegisterLog In

care-connect

See U.S. FULL PRESCRIBING INFORMATION for NUEDEXTA.
See U.S. FULL PRESCRIBING INFORMATION, including BOXED WARNING for ABILIFY MAINTENA, JYNARQUE, REXULTI, and SAMSCA.
See MEDICATION GUIDES for ABILIFY MAINTENA, JYNARQUE, REXULTI, and SAMSCA.

OPAF Care Connect Benefits

Apply online for your patients

Submit and manage your patient applications
from start to finish:

HCPs icon

Receive eligibility determination
within 2 business days

Work icon

Use your work space to find
patient
applications, consent
forms and
documents

Email icon

Email patient eConsent and HCP
eSignature for a seamless
application process

Patients icon

Store individual prescriber
information and patient prescription
details for quick product orders

Find documents
quickly
and easily

Access relevant patient documentation and treatment information in a secure, online location:

  • Search for patient information quickly with My Case Search
  • Initiate annual applications from existing patient case information
  • Store patient eConsent forms for future assistance applications

Get up-to-date and
timely notifications

Stay informed with email notifications for patient applications and product requests:

  • Get updates regarding your patient application status and determination results
  • Receive notifications when it’s time for annual patient reapplications
  • Track status of product shipments
Register now image

Register your
patient today

Prefer to fax in an application for your patient? Just follow these 3 simple steps:

  1. Download and print the application
  2. Collect all required documentation from your patient
  3. Fax the application and the documentation to OPAF at 1-844-727-6274

Please note: Faxed applications are processed within 5 business days. If this is a time-sensitive
request, please submit an application online.

See U.S. FULL PRESCRIBING INFORMATION for NUEDEXTA.
See U.S. FULL PRESCRIBING INFORMATION, including BOXED WARNING for ABILIFY MAINTENA, JYNARQUE, REXULTI, and SAMSCA.
See MEDICATION GUIDES for ABILIFY MAINTENA, JYNARQUE, REXULTI, and SAMSCA.

Have any questions image

To help expedite your patient’s application, be sure to include the proper documentation with your fax, including:

  1. Proof of income
  2. Proof of US Address

Have any questions?

Supported Medications

OPAF provides eligible patients no-cost support for the following prescribed medications:

NUEDEXTA Logo
ABILIFY MAINTENA logo
JYNARQUE logo
REXULTI logo
Samsca logo

See U.S. FULL PRESCRIBING INFORMATION for NUEDEXTA.
See U.S. FULL PRESCRIBING INFORMATION, including BOXED WARNING for ABILIFY MAINTENA, JYNARQUE, REXULTI, and SAMSCA.
See MEDICATION GUIDES for ABILIFY MAINTENA, JYNARQUE, REXULTI, and SAMSCA.

To report SUSPECTED ADVERSE REACTIONS, contact Otsuka America Pharmaceutical, Inc. at
1-800-438-9927 or FDA at 1-800-FDA-1088 (www.fda.gov/medwatch).

Otsuka America Pharmaceutical, Inc. does not control or influence how Otsuka Patient Assistance Foundation, Inc. distributes funds.

Secure messaging ensures patient privacy because it is a HIPAA-compliant, password-protected electronic messaging platform. You can communicate directly with an OPAF Patient Access Advocate without having to pick up the phone. Through the platform you can securely send electronic messages with any questions, communications, and documents at your convenience.

Because it is HIPAA-compliant, there is a one-time account activation process. The activation process takes less than 3 minutes. Once your account is active, you can send messages to OPAF immediately.

To setup your OPAF secure message account follow the steps below:

  • Click on the (button or envelope) below to start the process
  • The system will prompt you to enter your email address as a "New to SecureContact"
  • A verification email will be sent to the email address that you entered
  • In your email inbox, you will find a message from "[email protected]"
  • Open this message and click on the link to activate your account
  • Complete the account activation by creating a password
  • Your account is active, and you can securely send a message to OPAF

If you have any questions, please contact OPAF at 1-855-727-6274 8:00 AM - 8:00 PM ET.

MESSAGE US

Welcome to the Otsuka Patient Assistance Foundation, Inc.