Resources to help your patients manage out-of-pocket expenses for ALOXI®. Including information about the Eisai Assistance Program and the ALOXI® Patient Assistance Program.
Eisai has created the ALOXI® Patient Assistance Program for customers who need assistance paying for ALOXI®. This program provides ALOXI® at no cost to financially needy patients who meet program eligibility criteria.
Depending on your patient's financial situation and clinical status, resources may be available to help with your patient’s costs for ALOXI®. You, patients, family members, advocates or case managers can assist patients in understanding what kind of support may be available by calling the Eisai Assistance Program.
You can download a copy of the ALOXI® Patient Assistance Program enrollment form below or call 1-866-61-EISAI (1-866-613-4724) for more information. The enrollment form, insurance information, financial documentation, signature of the prescribing healthcare professional, and patient's signature are required for the form to be considered complete.
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
ALOXI® injection 20mcg/kg (max 1.5mg) is indicated in patients ≥ 1 month up to 17 years of age, for the prevention of acute nausea and vomiting associated with initial and repeat courses of emetogenic cancer chemotherapy, including highly emetogenic chemotherapy.
ALOXI® injection 0.25 mg is indicated in adults for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of moderately emetogenic chemotherapy, and the prevention of acute nausea and vomiting associated with initial and repeat courses of highly emetogenic chemotherapy.
For more information about ALOXI®,
please see full Prescribing Information.
You are encouraged to report negative side effects of prescription drugs to the FDA.
Visit http://www.FDA.gov/medwatch or call 1-800-FDA-1088.
This information is intended for use by our 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.
ALOXI® is a registered trademark of Helsinn Healthcare SA, Switzerland, used under license.
Distributed and marketed by Eisai Inc and Helsinn Therapeutics (U.S.), Inc.