Call 1-855-727-6274 or Fax 1-844-727-6274
New Provider Form ABILIFY MAINTENA® (aripiprazole) Medical Necessity Form
New Provider Form REXULTI® (brexpiprazole) Medical Necessity Form
New Provider Form SAMSCA®(tolvaptan) Medical Necessity Form
Re-initiation of Therapy Form SAMSCA®(tolvaptan)
Medical Necessity Letter SAMSCA®(tolvaptan)
New Provider Form JYNARQUE® (tolvaptan) Medical Necessity Form
Income Insurance Residency Attestation Letter
Vitamins Request Form
OPAF provides eligible patients no-cost support for the following prescribed medications:
See U.S. FULL PRESCRIBING INFORMATION for NUEDEXTA.
See U.S. FULL PRESCRIBING INFORMATION, including BOXED WARNING for
See MEDICATION GUIDES for
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:
If you have any questions, please contact OPAF at 1-855-727-6274 8:00 AM - 8:00 PM ET.
It's exciting to share that OPAF has started providing assistance to uninsured and underinsured patients who were prescribed certain medications.
See U.S. FULL PRESCRIBING INFORMATION, including BOXED WARNING for ABILIFY ASIMTUFII.
See MEDICATION GUIDES for ABILIFY ASIMTUFII.
Patients who qualified for Abilify Asimtufii assistance can benefit from additional offerings available through the OPAF Resource & Solutions Center.
If you are interested in learning more about OPAF’s offerings and would like to speak with Patient Access Advocate, please call OPAF at
