Otsuka_Patient_Assistance_Foundation_KO_Logo Otsuka_Patient_Assistance_Foundation_KO_Logo ABILIFY MAINTENA® (aripiprazole) JYNARQUE® (tolvaptan) REXULTI® (brexpiprazole) SAMSCA® (tolvaptan) $ R x

FAQs

Below are frequently asked questions about the Otsuka Patient Assistance Foundation, Inc. (OPAF). The FAQs provide guidance to patients, caregivers, and healthcare professionals (HCPs). If you have further questions, please call us at 1-855-727-6274.

General FAQs

OPAF is an organization that provides free treatment to eligible uninsured and underinsured patients on ABILIFY MAINTENA® (aripiprazole), JYNARQUE® (tolvaptan), REXULTI® (brexpiprazole), or SAMSCA® (tolvaptan) medications.

OPAF is funded by donations.

Currently OPAF only provides free medication to eligible patients.

Patient & Caregiver FAQs

No, only your healthcare professional [HCP] can submit an application on your behalf. However, to make the application process as smooth as possible, you can follow these easy steps:

  • If you qualify for assistance, download the application below and email it to your HCP or bring it with you to your next appointment. For faster processing, your HCP can apply for you online at OPAF Care Connect.
  • Gather all of the required documentation and provide it to your HCP; without the documentation, OPAF is unable to process your application. Please see the following FAQ for the required documentation. 

Please provide your HCP proof of income for all members of the household who file a tax return.

When you submit an application on behalf of a patient, please include proof of income for all members of the household who file a tax return. Acceptable documentation includes one of the following:

  • Federal Income Tax Return (1040, etc.)
  • W-2 from previous tax year
  • 1099-MISC form
  • Two most recent paystubs
  • Social Security award letter
  • Disability income information
  • Unemployment benefits letter
  • Letter from employer on company letterhead

The application must also include an acceptable proof of residency. Acceptable documentation includes one of the following:

  • Social Security number
  • State driver’s license
  • US birth certificate
  • US passport
  • Foreign passport with US visa
  • I-94 form with photograph
  • US military ID
  • US certificate of naturalization or citizenship

OPAF will review the application to ensure that it is complete. If additional information is required, OPAF will contact your healthcare professional.

Once the application is complete, OPAF will provide your healthcare professional a determination of benefits within 48 hours, if the application was submitted online; if the application was faxed to OPAF, determination of benefits can take up to 5 business days.

Patients, caregivers, and healthcare professionals can call 1-855-727-6274 to reach OPAF.

Healthcare Professional FAQs

When you submit an application on behalf of a patient, please include proof of income for all members of the household who file a tax return.

When you submit an application on behalf of a patient, please include proof of income for all members of the household who file a tax return. Acceptable documentation includes one of the following:

  • Federal Income Tax Return (1040, etc.)
  • W-2 from previous tax year
  • 1099-MISC form
  • Two most recent paystubs
  • Social Security award letter
  • Disability income information
  • Unemployment benefits letter
  • Letter from employer on company letterhead

The application must also include an acceptable proof of residency. Acceptable documentation includes one of the following:

  • Social Security number
  • State driver’s license
  • US birth certificate
  • US passport
  • Foreign passport with US visa
  • I-94 form with photograph
  • US military ID
  • US certificate of naturalization or citizenship

Patients receiving government-issued insurance (Medicare, Medicare Part D, Medicaid) need to reapply at the end of every calendar year. Qualified patients who are not on a government-issued insurance program must reapply every 12 months.

Medication will be sent to your patient’s home or directly to your office. The location is determined by the medication selected in the application.

Yes, patients must have a diagnosis that is within the drug's approved indication(s) to qualify for no-cost medications from OPAF. This means patients who are being treated with Otsuka medications for conditions not indicated in the medication's approved Prescribing Information will not qualify for free treatment. Please contact a Dedicated Patient Case Coordinator by dialing 1-855-727-6274 if further clarification is needed.

Only HCPs in the United States and Puerto Rico may register for and use the features of OPAF Care Connect.

No, access to OPAF Care Connect is limited to healthcare professionals. However, to help make the application process as seamless as possible, patients can check their eligibility and, if they qualify, send you the required documentation that you’ll need to submit an application on their behalf.

If you need any additional help, please call OPAF at 1-855-727-6274, Monday-Friday, 8 AM-8 PM (ET).

Supported Medications

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

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.

When you submit an application on behalf of a patient, please include proof of income for all members of the household who file a tax return. Acceptable documentation includes one of the following:

  • Federal Income Tax Return (1040, etc.)
  • W-2 from previous tax year
  • 1099-MISC form
  • Two most recent paystubs
  • Social Security award letter
  • Disability income information
  • Unemployment benefits letter
  • Letter from employer on company letterhead

The application must also include an acceptable proof of residency. Acceptable documentation includes one of the following:

  • Social Security number
  • State driver’s license
  • US birth certificate
  • US passport
  • Foreign passport with US visa
  • I-94 form with photograph
  • US military ID
  • US certificate of naturalization or citizenship