Jynarque Patient Assistance Programs

Jynarque: Apply for prescription assistance below

If you are eligible, the programs below can help you afford Jynarque. Review the information to see if you qualify. The applications are available in Adobe PDF format and should be mailed directly to the provider of the patient assistance program.

If you have any questions, please call the telephone number for the program (not PharmacyChecker.com) or go to the program website.

Looking for a different medication?

Otsuka Patient Assistance Foundation (OPAF) Patient Assistance Program

(Program 1 of 1 — Scroll down to see them all )

Provided by: Otsuka Patient Assistance Foundation, Inc.
Otsuka Patient Assistance Foundation, Inc. PO Box 3640 Gaithersburg, MD 20885-3640
TEL: 855-727-6274
FAX: 844-727-6274
Languages Spoken:
English, Others By Translation Service
Program Website
  • Jynarque (tolvaptan)
Eligibility Requirements
  • Insurance Status *Contact program for details.
  • Those with Part D Elibible? Varies
  • Income Varies
  • Diagnosis/Medical Criteria FDA-approved diagnosis
  • U.S. Residency Required? The patient must reside in the US, Puerto Rico or the USVI.
  • Obtaining Health care provider must complete online
  • Receiving Complete online or by phone
  • Returning The application must be submitted online by the health care provider
  • Doctor's Action Enroll in program, complete form and obtain patient consent
  • Applicant's Action Inform Doctor that he/she is in need
  • Decision Communicated Doctor notified
  • Decision Timeframe Not specified
  • Amount/Supply Varies
  • Sent To Varies
  • Delivery Time Not specified
  • Refill Proces Not specified
  • Limit Varies
  • Re-application Varies
Additional Information
Updated April 1, 2019

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