1-855-EISAI-4-U (1-855-347-2448)

Monday - Friday, 9 am to 5 pm ET

Patient Support

Below you will find resources to help your patients manage out-of-pocket expenses for BANZEL®. Including information about Eisai Assistance Program and the Rx Outreach Patient Assistance Program.

Eisai Assistance Program

The Eisai Assistance Program provides information to patients and healthcare professionals regarding the patient’s insurance benefits for coverage of BANZEL®. In addition, our agents can also provide information relating to payor-specific policies for the coverage of BANZEL®, information regarding billing and coding requirements, and answer questions regarding financial assistance options. Call the Eisai Assistance Program today for all of your billing, coding, coverage and financial assistance needs.

Contact Us

Eisai Assistance Program
Phone: 1-855-EISAI-4-U (1-855-347-2448)
Fax: 1-800-226-2059
Monday – Friday, 9 am to 5 pm ET

BANZEL® Savings Card Program*

Your patients can activate or register a card online at www.BanzelCard.com or by calling 1-855-EISAI-4-U

*Commercially insured patients pay the first $25 and Eisai Inc. will pay up to $50 per month. Most commercially insured patients will pay no more than $25 of their out-of-pocket expense. Maximum benefit paid by Eisai Inc. will be $50 per month. You could have additional financial responsibility depending on your insurance plan. Cash patients pay the first $25 and Eisai Inc. will pay up to $60 per month. For questions, please call 1-855-EISAI-4-U (1-855-347-2448).

Eligibility Criteria

Good toward the purchase of BANZEL® prescriptions. No substitutions permitted. Save this card to reuse with each prescription. Not available to patients enrolled in state or federal healthcare programs, including Medicare, Medicaid, Medigap, VA, DoD, or TRICARE. Offer available to MA residents through March 31, 2017. May not be combined with any other coupon, discount, prescription savings card, free trial, or other offer. Federal law prohibits the selling, purchasing, trading, or counterfeiting of this card. Such activities may result in imprisonment of 10 years, fines up to $25,000, or both. Void outside the USA and where prohibited by law. Eisai Inc. reserves the right to rescind, revoke, or amend this offer at any time without notice. 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 on third-party payors. 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 BANZEL®. Use of the card for any one purchase does not obligate the patient to make future purchases of BANZEL® or any other product. This offer will expire July 31, 2019.

The Rx Outreach Patient Assistance Program®

Rx Outreach is a non-profit pharmacy making medications affordable for you and your family. The Rx Outreach Patient Assistance Program is for patients who are unable to afford their prescriptions and who meet specific financial and other eligibility criteria. Eisai has partnered with Rx Outreach to provide BANZEL® at low cost to financially needy patients who meet program eligibility criteria.

This includes patients who do not have insurance or other third-party payor prescription coverage, including Medicaid, Medicare, or managed care coverage.

For more information, including program eligibility requirements, please call 1-888-796-1234.

Fax: 1-888-430-9818

Hours: Monday-Friday, 7:00 AM-5:30 PM (Central Time).

Find Information on Medicaid Coverage

Learn about coverage alternatives for BANZEL® including Medicaid coverage

BANZEL® Offers Flexible Dosing Options

Learn about dosing options and sample titration schedules

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

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Indication

BANZEL® (rufinamide) is indicated for adjunctive treatment of seizures associated with Lennox-Gastaut Syndrome (LGS) in pediatric patients 1 year of age and older, and in adults

Important Safety Information

Contraindication:

  • BANZEL® is contraindicated in patients with Familial Short QT syndrome.

Warnings:

  • AEDs increase the risk of suicidal thoughts or behavior in patients. Patients, their caregivers, and families should be informed of the risk and advised to monitor and report any emergence or worsening of depression, suicidal thoughts or behavior, or any unusual changes in mood or behavior, or thoughts of self-harm. If these symptoms occur, consider if it may be related to the AED or illness because epilepsy itself can increase these risks.
  • Use of BANZEL® has been associated with central nervous system–related adverse reactions, such as somnolence or fatigue, coordination abnormalities, dizziness, gait disturbances, and ataxia.

Precautions:

  • Formal cardiac ECG studies demonstrated shortening of the QT interval (mean = 20 msec, for doses ≥ 2400 mg twice daily) with BANZEL®. Caution should be used when administering BANZEL® with other drugs that shorten the QT interval.
  • Multi-organ hypersensitivity syndrome has been reported in association with BANZEL® therapy. In clinical trials, hypersensitivity reactions occurred in children less than 12 years of age and within 4 weeks of starting BANZEL® therapy. In addition, rare cases of Drug Reaction with Eosinophilia and Systemic Symptoms and Stevens-Johnson syndrome have been reported in association with rufinamide therapy post marketing. If any of these reactions are suspected, BANZEL® should be discontinued and alternative treatment started. All patients who develop a rash while taking BANZEL® must be closely supervised.
  • As with all AEDs, BANZEL® should be gradually withdrawn to minimize the risk of increased seizure frequency.

Adverse reactions:

  • In the pooled, double-blind, adjunctive therapy studies in adults and pediatric patients ages 4 and older, the most commonly observed (≥10%) adverse reactions with BANZEL® vs placebo, respectively, were headache (25% vs 20%), dizziness (17% vs 10%), fatigue (15% vs 9%), somnolence (13% vs 9%), and nausea (11% vs 7%).
  • In a multicenter, parallel group, open-label study in pediatric patients (1 year to less than 4 years of age) the most commonly observed (≥10%) adverse reactions and with a higher frequency with BANZEL® vs any other AED, respectively, were vomiting (24 % vs 9%), somnolence (16% vs 0%), constipation (12% vs 9%), cough (12% vs 9%), bronchitis (12% vs 0%), rash (12% vs 9%), and decreased appetite (12% vs 9%).

For more information about BANZEL® please see Prescribing Information.

 

BANZEL® is available by prescription only.

BANZEL® Contact 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.

BANZEL® is a registered trademark of Eisai R&D Management Co., Ltd., licensed to Eisai Inc.

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