For eligible patients with commercial insurance EarlyAssist™

Easy and early assistance with ELMIRON® (pentosan polysulfate sodium) co-pays

For a limited time only, patients can pay as little as $5 per month for their ELMIRON® prescription for up to 4 months.

Commercially eligible patients can access and print their EarlyAssist™ Savings Card at www.orthoelmiron.com to start saving on their prescription costs.

  • Use the same card once a month for a total of 4 uses for this program with a valid prescription for ELMIRON®
  • Patients may be eligible to receive UP TO $35 off their out-of-pocket expenses for each of 4 ELMIRON® prescriptions. Patient will be responsible for the initial $5 of each monthly bill

For patients without commercial insurance

If patients don't have prescription drug coverage, they can find out more about assistance programs that could provide discounted or free prescriptions at www.JanssenPrescriptionAssistance.com. Janssen Prescription Assistance provides information about programs sponsored by Janssen Pharmaceuticals Companies as well as independent foundations that may have available funding.

Elmiron® Early Assistance card