Eisai Patient Support offers access and reimbursement support for patients prescribed LENVIMA.
For more information, search LENVIMA in this Guide, go online, or call 1-866-613-4724, Monday through Friday.
Oncology-related products: Lenvima® (lenvatinib) capsules
Eisai Patient Support offers access and reimbursement support, including:
For more information on Eisai Patient Support, and to review the terms and conditions, visit www.eisaipatientsupport.com or call 1-866-613-4724.
$0 Co-Pay Program
Eligible, commercially insured patients prescribed Lenvima could pay as little as $0 out of pocket for each prescription. Eisai will pay up to $10,000 per year to assist with the out-ofpocket costs for Lenvima. Depending on the insurance plan, a patient could have additional financial responsibility for any amounts over Eisai's maximum liability. Commercial insurance required. This program is not available to patients enrolled in state or federal healthcare programs, including Medicare, Medicaid, Medigap, VA, DoD, or TRICARE.
For questions about the program, call 1-855-347-2448 or visit www.eisaipatientsupport.com/lenvima for full terms and conditions.
Lenvima Patient Assistance Program
The Lenvima Patient Assistance Program is for patients who need help paying for Lenvima. This program provides Lenvima at no cost to uninsured and financially burdened patients who meet the program eligibility criteria.
Complete the Lenvima Eisai Patient Support Enrollment Form and fax it to Eisa Patient Support at 1-855-246-5192.
Health care professionals can also enroll patients by sending an electronic prescription for Lenvima directly to Eisai Patient Support Pharmacy.
Note: A patient's signature is required to complete enrollment. Patients can sign the form electronically online.
Lenvima Dose Exchange Program
There may be times when a healthcare provider needs to dose reduce a patient during the course of Lenvima treatment due to an adverse reaction before the patient has finished their current supply. Through the Lenvima Dose Exchange Program, eligible patients who require a dose reduction can exchange up to 15 unused doses for the same number of doses at the reduced dose strength at no additional cost.
The program allows patients to exchange unused 20-mg doses for 14-mg doses and 10-mg doses to 8mg doses when a healthcare provider has directed a dose reduction based on the prescribing information.
Complete the Lenvima Dose Exchange Enrollment Form and fax it to Eisai Patient Support at 1-855-246-5192.
Lenvima Temporary Supply Program
Through the LENVIMA Temporary Supply Program, eligible patients may receive up to a 30day supply of LENVIMA (dispensed in up to three 10-day increments) while awaiting a coverage determination from their insurance provider.
Complete the LENVIMA Temporary Supply Program Enrollment Form and fax to 1-855246-5192.
Halaven $0 Co-Pay Program
Eligible, commercially insured patients could pay as little as $0 out of pocket for each prescription. Eisai will pay up to $18,000 per year to assist with the out-of-pocket costs for Halaven. Depending on the insurance plan, a patient could have additional financial responsibility for any amounts over Eisai’s maximum liability.
To enroll, fax the completed enrollment form to 1-844-745-2350.
For questions about the program and full terms and conditions, visit https://www.halaven.com/hcp/metastatic-breast-cancer/patient-assistance.