Eisai

Patient Support Services Guide 2018


Eisai Reimbursement Resources
855-347-2448
866-613-4724

Eisai Reimbursement Resources is a program designed to offer drug-specific assistance related to the coding, coverage, and reimbursement of select Eisai drugs, as well as a variety of patient assistance services for patients who are prescribed Eisai’s drugs and who are having difficulty paying for the cost of their care.

Eisai oncology drugs covered through Eisai Reimbursement Resources are listed in the Table.

The resources provided by Eisai Reimbursement Resources are drug-­specific; therefore, patients and providers are encouraged to visit EisaiReimbursement.com and select their prescribed medication for more information on programs specific to that drug.

These resources are available for patients in a variety of care settings and with different types of insurance coverage, including government and commercial insurance.

For more information visit EisaiReimbursement.com.

Eligibility

$0 Co-Pay Program

For commercially insured patients who have been prescribed an Eisai medication, drug-specific savings programs may be available.

The $0 Co-Pay Program provides assistance for patients with commercial insurance who have been prescribed Halaven (eribulin mesylate) or Lenvima (lenvatinib).

Eisai Assistance Program

Through the drug-specific assistance programs, certain medications may be available at low cost or no cost to financially needy patients who meet the program’s eligibility criteria, including US residency, income status, and site-of-service specifications.

Coverage and payment depend on the patient’s insurance plan. Drug-­specific reimbursement information, insurance verification processing, prior authorization information, and guidance regarding denied claims may also be available with the Eisai Assistance Program.

For drug-specific information, please call 866-613-4724 or visit EisaiReimbursement.com.

Halaven $0 Co-Pay Program

Most patients who have been prescribed Halaven for an approved indication, through this program will pay $0 of their medication cost-sharing (coinsurance), and Eisai will pay up to a maximum of $18,000 annually of the medication cost that is not covered by insurance.

Lenvima $0 Co-Pay Program

Through this program, most patients who have been prescribed Lenvima for an approved indication will pay $0 of their cost-sharing (coinsurance), and Eisai will pay up to a maximum of $40,000 annually of the medication cost that is not covered by insurance.

Depending on the insurance plan, additional financial responsibilities may be required. The savings program cannot be used in combination with other coupons or offers, and is not available to patients with state or federal healthcare programs. For more information, visit the specific website listed in the Table.

Eisai Oncology Patient Assistance Program

Patients who need assistance paying for their Eisai oncology medication should apply to the Eisai Oncology Patient Assistance Program, available at EisaiReimbursement.com. Patients with financial needs who meet the program eligibility criteria may receive Aloxi (palonosetron hydrochloride injection), Halaven, or Lenvima at no cost through the Partnership for Prescription Assistance program.

Application & Enrollment

The completed enrollment forms for the Eisai Assistance Program or $0 Co-Pay Program should be faxed or mailed, together with a valid prescription, to the respective fax number or address listed on the drug-specific form, which can be accessed via EisaiReimbursement.com. Application to the Eisai Oncology Patient Assistance Program should be mailed to the address on the application form. Healthcare providers can call the drug-specific Patient Assistance Program at 866-613-4724, to determine patient eligibility.

A copy of the patient’s insurance card, and any financial documents, should be attached. Accepted financial documents include a federal tax return, a Social Security benefit statement, and 1 month of paycheck stubs, unemployment statements, or disability statements.

Eisai Oncology/Supportive Care Drugs

Drugs
Indications
Patient support programs

Drug
Aloxi (palonosetron hydrochloride) injection
Indication
Chemotherapy-induced nausea and vomiting

Drug
Halaven (eribulin mesylate)
Indication
Metastatic breast cancer; unresectable or metastatic liposarcoma

Drug
Lenvima (lenvatinib)
Indication
Progressing differentiated thyroid cancer; advanced renal-cell cancer, in combination with everolimus