Intelence

(etravirine)
etravirine 100 MG Oral Tablet [Intelence]etravirine 200 MG Oral Tablet [Intelence]
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NO BLACK BOX WARNING

Dosage & administration

drug label

Intelence prescribing information

Have more Intelence questions?

Submit MSL Request
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Need to report an Intelence issue?

ONLINE FORM
Report adverse event
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samples

Request Intelence samples

NOT PROVIDED BY BRAND
View Online Sample Form
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prior authorization

Intelence Prior authorization resources

Complete Letter of Medical Necessity

NOT PROVIDED BY BRAND
Coverage Authorization Request

NOT PROVIDED BY BRAND
Coverage Authorization Appeals
PA Checklist
Formulary Exceptions Checklist
Formulary Exceptions Checklist - Spanish
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Benefits investigation

Benefits Investigation Form
Janssen Patient Support Program Patient Authorization Form
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Reimbursement help (FRM)

NOT PROVIDED BY BRAND
Reimbursement help (FRM) resources
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financial assistance

Intelence Financial assistance options

Co-pay savings program

commercial only
Enroll in Patient Savings Program
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Bridge program

commercial only
Learn More

Foundation programs

under insured
no insurance
goverment insurance
65+
J & J Patient Assistance Foundation Eligibility Check
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patient education

Intelence Patient education

Getting started on Intelence

NOT PROVIDED BY BRAND
Instructions For Use: HIV

Patient toolkit

View How to Take Intelence
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Side Effects
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Patient Resources
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Learn More

Can't find what you're looking for?

Our trained staff can help you:
Please note:
  • Access to a Field Reimbursement Manager (FRM) or Medical Science Liaison (MSL) varies by brand and may require talking with your rep first.
  • Samples are provided at the discretion of the brand.
  • We are unable to collect Protected Health Information (PHI), fill out forms, or submit them on your behalf.