Jelmyto Coupon & Prices

Your monthly Jelmyto cost savings if eligible

The Jelmyto patient assistance program can provide your medication for free. We simply charge $49 per month for each medication to cover the cost of our services. With NiceRx, you will only pay $49 to obtain your Jelmyto, regardless of the retail price.

Am I eligible for the Jelmyto patient assistance program?

To find out if you are eligible for Jelmyto assistance you can apply online using our enrollment application. Each pharmaceutical company sets its eligibility criteria, and we will review your application individually to determine if you may be eligible. The three main factors to consider are:

• I am a permanent, legal resident of the United States or Puerto Rico
• I am uninsured or my insurance doesn’t cover my medication
• I meet certain income eligibility requirements

How do I apply for the Jelmyto patient assistance program?

Our application process aims to make it as easy as possible to apply for the Jelmyto patient assistance program. The first step is to complete our online enrollment application. We will ask you for details about your healthcare provider, your insurance plan, and your household income as this information is required by the pharmaceutical companies. We may be able to help you apply for other patient assistance programs too, so be sure to tell us about any medications you are taking as well as Jelmyto.

NiceRx will review your application and determine whether you may be eligible for Jelmyto assistance. If so, we will handle the full enrollment process for you and prepare all required documents for your healthcare provider to sign. Once you are successfully enrolled in the Jelmyto patient assistance program, we will help you manage your prescription refills by requesting refills on your behalf throughout your enrollment period. At the end of your enrollment period, we will contact you for updated information and seek to re-enroll you so you can continue to access affordable Jelmyto.

Is NiceRx a Jelmyto coupons provider?

NiceRx is a service provider that helps eligible individuals access the Jelmyto patient assistance program. We do not offer trial offers or free Jelmyto samples. When obtaining your medication through NiceRx, you will only pay $49 a month per medication. This will likely save you more money than if you were to use Jelmyto coupons, discount cards, or Jelmyto copay cards.

Can NiceRx help me get Jelmyto if I have insurance?

NiceRx may be able to help you if your insurance company will not pay for your Jelmyto medication. We may also be able to help if you have a high copay or coinsurance responsibility. Whether you have insurance or not, apply online using our enrollment application to find out more.

How much does Jelmyto cost without insurance?

Jelmyto prices without insurance will vary depending on how much you buy. Prices will also vary by retailer. As a guide, Jelmyto ureteral kit 40 mg typically costs $22,700 for 1 kit.

How much does Jelmyto cost with insurance?

The copay for Jelmyto will vary by the terms of your healthcare plan. To find out what you might need to pay for Jelmyto with insurance, your insurance provider or pharmacist will be able to help you calculate the copay costs with your current insurance.

What is Jelmyto?

Jelmyto is an FDA (U.S. Food and Drug Administration) approved medication manufactured by UroGen Pharma, Inc. It was granted approval on the basis of data from the Phase III Olympus trial. Jelmyto is an alkylating drug indicated for the treatment of low-grade upper tract urothelial cancer, LG-UTUC, (bladder cancer) in adult patients.

What doses of Jelmyto are available?

Jelmyto is available in pyelocalyceal solution form, in the following doses: Two 40 mg (each) single-dose vials of mitomycin for pyelocalyceal solution, one vial of 20 mL sterile hydrogel for reconstitution.

Your healthcare provider will carry out blood tests prior to each treatment to check your blood cell counts during treatment. Jelmyto is for pyelocalyceal use only and not for intravenous use, topical use, or oral administration.

Administer 1.3 g of sodium bicarbonate orally the evening prior to, the morning of, and 30 minutes prior to instillation procedure (total of 3.9 g). Instill 4 mg per mL of Jelmyto via the ureteral catheter or nephrostomy tube to the renal pelvis and calyces, with total instillation volume based on volumetric measurements using pyelography. Do not exceed 15 mL (60 mg of mitomycin). Instill Jelmyto once weekly for six weeks. For patients with a complete response 3 months after initiation, further Jelmyto instillations may be given once a month for a maximum of 11 additional instillations.

Please read the prescribing information and instructions for administration, and always speak with a healthcare professional about any changes to your dose so they can monitor and evaluate your condition.

Jelmyto active ingredients

Jelmyto contains mitomycin as the active ingredient.

Jelmyto side effects

The most common side effects of Jelmyto in clinical trials include:

• Ureteric obstruction
• Flank pain (side pain)
• Urinary tract infection
• Hematuria (blood in your urine)
• Renal dysfunction (kidney problems – impairment of kidney function)
• Tiredness
• Nausea, vomiting
• Abdominal pain
• Dysuria

In rare instances, Jelmyto can cause more serious side effects. These can include:

• Ureteric obstruction – transient or long-term ureteral stents or alternative procedures may be required
• Bone marrow suppression – thrombocytopenia and neutropenia may occur
• Embryo-fetal toxicity

Your doctor will assess the benefits of using Jelmyto against your risk of side effects. Patients are encouraged to report negative side effects or adverse reactions of Jelmyto to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Jelmyto drug interactions

Jelmyto can interact with other medications. These include:

• Vaccines – BCG, measles, mumps, rubella, smallpox, yellow fever
• DMARDs – leflunomide, teriflunomide
• Immunosuppressants – fingolimod, ozanimod, siponimod
• Antipsychotics – clozapine

This list is not exhaustive and other prescription drugs may interact with Jelmyto.

Jelmyto contraindications

You should not use Jelmyto if you:

• Are allergic to the active ingredient mitomycin
• Are allergic to any of the other ingredients in Jelmyto
• Have perforation of the bladder or upper urinary tract
• Are pregnant or are planning to become pregnant – use effective contraception during treatment and for 6 months after the last dose
• Are breastfeeding or are planning to breastfeed

Talk to your doctor before using Jelmyto if you:

• Are taking any of the medications that could interact with Jelmyto

Jelmyto generic

Jelmyto is the trademark brand name for mitomycin manufactured by UroGen Pharma, Inc. A generic version of mitomycin is not available. Generic drugs are generally cheaper than brand-name drugs, but you can still find Jelmyto savings through NiceRx.