The Eisai Assistance Program can provide information to patients and healthcare professionals about coverage for BELVIQ® or BELVIQ XR® and programs to help patients afford their medication. As a resource for you, Eisai has also developed an online portal to enable you to research your patients’ insurance coverage for BELVIQ® or BELVIQ XR®. The portal is easy to use and can quickly provide you BELVIQ® or BELVIQ XR® coverage information for your patients.
Click here to access the Provider Insurance Verification Portal for BELVIQ® or BELVIQ XR®.
The Eisai Assistance Program can also provide information about the Patient Assistance Program for BELVIQ® which provides support to customers who need assistance paying for BELVIQ®. This program provides BELVIQ® at low cost to financially needy patients who meet program eligibility criteria.
If your patients’ commercial insurance covers BELVIQ® or BELVIQ XR®, simply use this program to Save Up to $160 on every 30 day supply.**
If your patient doesn’t have commercial coverage for BELVIQ® or BELVIQ XR®, or if they pay cash for their prescription or have Medicare Part D, we can help! Use this program to Save Up to $185 on every 30 day supply.**
* Not available to patients who are eligible for state or federal healthcare programs. Please refer to complete Restrictions and Conditions of Use below.
**Out of Pocket Costs, for saving card users, on average for Commercial coverage are ≤ $35 or less. If you have not reached your plan deductible, out of pocket costs may be higher. For Cash pay, average out of pocket costs are ≤ $95 based on McKesson Cost/Coverage data 2015.
Good toward the purchase of prescriptions for BELVIQ® (lorcaserin HCI) CIV or BELVIQ XR® (lorcaserin HCI) CIV for up to 12 uses per year. Limited to 1 prescription per patient for any 30-day period. Eisai Inc. will contribute no more than $160 per Commercially Insured, covered prescription and no more than $185 per Cash, Medicare D insured, or commercially insured, not covered prescriptions. Save the card to reuse each month up to the expiration date. No substitutions permitted.
Must be 18 years of age or older.
Not available to individuals eligible for federal healthcare programs that cover prescription drugs, including Medicare, Medicaid, MediGap, VA, DOD, TRICARE, or any similar state or federal healthcare programs. However, Medicare Part D patients may use this card if paying the full cash price for a prescription covered by this card and no claim is submitted to Medicare or any other federal, state, or other governmental program. Out-of-pocket expenses incurred using this card cannot be applied towards Medicare Part D true out-of-pocket (TrOOP) expenses.
Not valid for prescriptions for BELVIQ or BELVIQ XR reimbursed in full by any third-party payer.
Patients and pharmacies are responsible for disclosing to insurance carriers the redemption and value of the card and complying with any other conditions imposed by insurance carriers or third-party payers.
May not be combined with any other coupon, discount, prescription savings card, free trial, or other offer.
The value of this card is not contingent on any prior or future purchases. The card is solely intended to provide savings on any purchase of BELVIQ or BELVIQ XR. Use of the card for any single purchase does not obligate the patient to make future purchases of BELVIQ or BELVIQ XR or any other product.
Void outside the USA and where prohibited by law.
This card expires 03/31/2018..
Federal law prohibits the selling, purchasing, trading, or counterfeiting of this savings card; such activities may result in imprisonment of 10 years, fines of $250,000, or both.
Eisai Inc. reserves the right to rescind, revoke, or amend this offer without notice at any time.
Other restrictions apply.
Eisai has created the Patient Assistance Program for BELVIQ® for customers who need assistance paying for BELVIQ®. This program provides BELVIQ® at low cost to financially needy patients who meet program eligibility criteria.Patients can call the BELVIQ® Patient Assistance Program at 1-866-61-EISAI (1-866-613-4724) to determine eligibility. The hours of operation are Monday through Friday, 8 am to 8 pm ET. BELVIQ XR® is not available through the Patient Assistance Program at this time.
Eisai reserves the right, at its sole discretion, to discontinue the Patient Assistance Program or change the qualifications at any time. All patient information remains confidential. Product supply for the program depends upon availability.
Eisai cannot guarantee payment of any claim. Coding, coverage, and reimbursement may vary significantly by payor, plan, patient, and setting of care. Actual coverage and reimbursement decisions are made by individual payors following the receipt of claims. For additional information, customers should consult with their payors for all relevant coding, reimbursement, and coverage requirements. It is the sole responsibility of the provider to select the proper code and ensure the accuracy of all claims used in seeking reimbursement. All services must be medically appropriate and properly supported in the patient medical record
BELVIQ® and BELVIQ XR® are indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of 30 kg/m2 or greater (obese), or 27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbid condition (e.g., hypertension, dyslipidemia, type 2 diabetes).
This information is intended for use by healthcare professionals in the United States only. Eisai Inc. recognizes the Internet is a global communications medium; however, laws, regulatory requirements, and medical practices for pharmaceutical products vary from country to country. The Prescribing Information included here is not appropriate for use outside the United States. This site contains information about products that may have different product labeling in different countries. This site is published by Eisai Inc.
BELVIQ® and BELVIQ XR® are registered trademarks of Arena Pharmaceuticals GmbH.