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Specialty Pharmacies offer Special Pricing

*Restrictions may apply. See Eligibility for more details.

Specialty pharmacies maximize benefits like these:

Copay
Assistance

JATENZO
Home Delivery

Refill
Reminders

Insurance
Support

PHARMACIES

National Network Pharmacies

Retail Pharmacies

Sterling Pharmacy
eRX NCPDP:	2433693
NPI:	1225548480
PHONE:	(888) 618-4126
FAX:	(866) 588-0371
HOURS:	Mon–Fri 7:30am–5:30pm ET

Invictus Pharmacy
eRX NCPDP:	3155377
NPI:	1073007340
PHONE:	(201) 991-0800
FAX:	(201) 991-1980
HOURS:	Mon–Fri 9:00am–5:00pm ET

Eligible patients with commercial insurance may
pay as little as $0 for every JATENZO prescription
with no cap on copay assistance*

With approved commercial insurance, patient may pay as little as $0
If commercial insurance rejects coverage, patient may pay $150

*Restrictions may apply. A maximum benefit per calendar year will be applied. See Eligibility for more details.

Download the Savings Card

SUPPORT ASSETS

Useful tools and information for you and your patients

Medical Information Request Form

Have a medical question? Our Medical Affairs team is here to help.

Patient  Discussion Guide

See what some of your patients may be most concerned about.

JATENZO Network Pharmacies

Connect patients with our network pharmacies.

Patient Education Guide

Provide info for patients looking to switch to an oral TRT.

Sterling Pharmacy Prior Authorization Form

Use this check list to start your patient on JATENZO

Invictus Pharmacy Prior Authorization Form

Use this check list to start your patient on JATENZO

ABC Pharmacy Prior Authorization Form

Use this check list to start your patient on JATENZO

Anchor Pharmacy Prior Authorization Form

Use this check list to start your patient on JATENZO

Choice Pharmacy Prior Authorization Form

Use this check list to start your patient on JATENZO

John's Pharmacy Prior Authorization Form

Use this check list to start your patient on JATENZO

Village Discount Drugs Prior Authorization Form

Use this check list to start your patient on JATENZO

Allied Pharmacy Prior Authorization Form

Use this check list to start your patient on JATENZO

TRT=testosterone replacement therapy

REQUEST AN ACCOUNT MANAGER AND/OR MEDICAL INFORMATION

Have a JATENZO question?

Connect with an account manager and/or request medical information about JATENZO clinical trials, safety, and support.

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Medical information request form

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By checking this box and typing my name, I hereby confirm that the medical information and/or inquiry requested was at my initiation and was not solicited in any manner by a Tolmar sales person or other personnel. The wording above accurately reflects the medical information I hereby request to be provided to me by Tolmar Medical Affairs.

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Indication and Limitations of Use:

JATENZO^® (testosterone undecanoate) capsules, CIII, is an androgen indicated for testosterone replacement therapy in adult males for conditions associated with a deficiency or absence of endogenous testosterone:

Primary hypogonadism (congenital or acquired)
Hypogonadotropic hypogonadism (congenital or acquired)

Safety and efficacy of JATENZO in men with “age-related hypogonadism” and in males less than 18 years old have not been established.

IMPORTANT SAFETY INFORMATION FOR JATENZO (testosterone undecanoate)

CONTRAINDICATIONS

JATENZO is contraindicated in men with carcinoma of the breast or known or suspected carcinoma of the prostate, in women who are pregnant, or in men with a known hypersensitivity to JATENZO or its ingredients.

WARNINGS AND PRECAUTIONS

Increase in hematocrit and polycythemia. High red blood cell counts increase the risk of clots, strokes, and heart attacks.

Venous thromboembolic events (VTE). Deep vein thrombosis (DVT) and pulmonary embolism (PE) have been reported in patients using testosterone replacement products like JATENZO.

Benign prostatic hyperplasia (BPH). Patients may see worsening signs and symptoms of BPH.

Prostate cancer. Patients treated with androgens may be at increased risk for prostate cancer.

Blood pressure increases. JATENZO can increase blood pressure. Monitor blood pressure periodically in men using JATENZO. Not recommended for use with uncontrolled hypertension.

Abuse. Testosterone has been subject to abuse, typically at doses higher than recommended for the approved indication and in combination with other anabolic androgenic steroids. Testosterone abuse can lead to serious cardiovascular and psychiatric adverse reactions.

Suppression of spermatogenesis. Large doses of androgens, like JATENZO, can suppress spermatogenesis.

Hepatic adverse events. JATENZO is not known to cause liver adverse events; however, patients should be instructed to report any signs of hepatic dysfunction.

Retention of sodium and water.

Gynecomastia.

Sleep apnea. Testosterone may potentiate sleep apnea in some patients, especially those with risk factors such as obesity or chronic lung disease.

Changes in the serum lipid profile may require dose adjustment of lipid-lowering drugs or discontinuation of testosterone therapy.

Risk of hypercalcemia.

ADVERSE EVENTS

The most common adverse events of JATENZO (incidence ≥2%) are headache (5%), increased hematocrit (5%), hypertension (4%), decreased HDL (3%), and nausea (2%).

DRUG INTERACTIONS

JATENZO can cause changes in insulin sensitivity or glycemic control and changes in anticoagulant activity. Use of testosterone and corticosteroids concurrently may increase fluid retention. Use of prescription and nonprescription analgesic cold medications with JATENZO have been known to increase blood pressure.

To report suspected adverse reactions contact Tolmar at 1-844-4TOLMAR (486-5627) or the FDA at 1-800-FDA-1088 or visit www.fda.gov/medwatch.

Please see full Prescribing Information.

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ELIGIBILITY REQUIREMENTS

With the JATENZO^® Copay Card, eligible patients with commercial insurance may pay as little as $0 for their monthly prescription. Copay assistance will cover up to $393 for a 1-month supply of JATENZO 237 mg. Eligible commercial insurance patients whose prescription coverage was denied, may elect to purchase a 1-month supply of JATENZO through a contracted network pharmacy for $150. Cash patients, and those who choose not to use insurance, can purchase a 1-month supply of JATENZO for $185. This offer is not valid for government insured patients. A valid Prescriber ID# is required on the prescription.
Patient Instructions: To redeem this offer, you must have a valid prescription for JATENZO. Follow the dosage instructions given by the doctor. This offer may not be redeemed for cash. By using this offer, you are certifying that you meet the eligibility criteria and will comply with the terms and conditions described in the Restrictions section below. Patients with questions about the JATENZO Savings Card offer should call 773-756-5798.
Pharmacist: When you apply this offer, you are certifying that you have not submitted a claim for reimbursement under any federal, state, or other governmental programs for this prescription. Participation in this program must comply with all applicable laws and regulations as a pharmacy provider. By participating in this program, you are certifying that you will comply with the terms and conditions described in the Restrictions section below.
Pharmacist Instructions for a Patient with an Eligible Third Party: Submit the claim to the primary Third-Party Payer first, then submit the balance due to PDMI as a Secondary Payer COB (coordination of benefits) with patient responsibility amount and a valid Other Coverage Code, (e.g., 8). The patient is responsible for as little as $0 for their monthly prescriptions. Reimbursement will be received from PDMI. Valid Other Coverage Code required. For any questions regarding PDMI online processing, please call the Help Desk at 316-219-4802.
Restrictions: This offer is valid in the United States and Puerto Rico. Offer not valid for prescriptions reimbursed under Medicaid, a Medicare drug benefit plan, TRICARE, or other federal or state health programs (such as medical assistance programs). Cash discount cards and other noninsurance plans are not valid as primary under this offer. If the patient is eligible for drug benefits under any such program, the patient cannot use this offer. By using this offer, the patient certifies that he will comply with any terms of his health insurance contract requiring notification to his payer of the existence and/or value of this offer. Offer not valid for patients under 18 years of age. It is illegal to (or offer to) sell, purchase, or trade this offer. This offer is not transferable and is limited to one offer per person. Not valid if reproduced. Void where prohibited by law. Tolmar reserves the right to rescind, revoke, or amend this offer without notice at any time.