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

Monday - Friday, 9 am to 5 pm ET

Financial Assistance

Eisai Assistance Program

The Eisai Assistance Program can provide information to patients and healthcare professionals about coverage for BANZEL® and programs to help patients afford their medication. Depending on your financial situation and clinical status, resources may be available to help with patient costs for BANZEL®.

The Eisai Assistance Program can also provide information about the BANZEL® Patient Assistance Program which provides support to customers who need assistance paying for BANZEL®. This program provides BANZEL® at no cost to financially needy patients who meet program eligibility criteria.

Have Your Physician’s Office 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*

You 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 federal or state 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.

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).

Do You Need Educational Assistance?

Programs run by Patient Support Foundations offer financial and educational assistance

What is Lennox-Gastaut syndrome (LGS)?

Lennox-Gastaut syndrome (LGS) is a rare and severe form of epilepsy

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 a prescription medication approved for the 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

Patients with a history of Familial Short QT syndrome should not be treated with BANZEL®. Talk to your healthcare provider if you are unsure if this affects you or your loved one. BANZEL® has been shown to reduce the QT interval. Caution should be used when administering BANZEL® with other drugs that shorten the QT interval.

All medications to treat seizures, including BANZEL®, may cause suicidal thoughts or actions in a very small number of people, about 1 in 500. Call your healthcare provider right away if you or your loved one experiences new or worsening symptoms of depression, unusual changes in mood or behavior, thoughts or actions about suicide or self-harm, aggression, agitation, anger, anxiety, or irritability.

Use of BANZEL® has been associated with side effects such as sleepiness or feeling tired, difficulty with coordination, dizziness, and problems with walking or movement.

Do not drive, operate heavy machinery, or do other dangerous activities until you know how BANZEL® affects you. BANZEL® can slow your thinking and motor skills.

— Alcohol, in combination with BANZEL®, may increase or worsen these side effects.

Call your healthcare provider if you or your loved one experiences a rash. This can be a sign of a more serious condition, such as multi-organ hypersensitivity reaction.

You or your loved one should take BANZEL® only as prescribed. Do not stop taking BANZEL® without first talking to your healthcare provider. Stopping BANZEL® suddenly can cause serious problems.

Tell your healthcare provider about all the medications you or your loved one takes, including prescription and non-prescription medications, vitamins, and herbal supplements. Using BANZEL® with certain medications can affect each other, causing side effects.

In studies, the most commonly observed (≥10%) side effects with BANZEL® were headache, dizziness, feeling tired, sleepiness, and nausea.

Important Safety Information for Women

BANZEL® may make hormonal contraceptives (birth control pills) less effective. Additional non-hormonal forms of birth control are recommended when using BANZEL®.

Healthcare providers should be informed if patients are pregnant or planning on becoming pregnant.

Also, BANZEL® is likely to be passed through breast milk to the baby and could cause serious side effects in the baby. A decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

Patients who are pregnant are encouraged to enroll in the North American Antiepileptic Drug Pregnancy Registry. This can be done by calling the toll-free number 1-888-233-2334. Additional information about the registry can be found at www.aedpregnancyregistry.org.

BANZEL® Contact Information

For more information about BANZEL® please see Prescribing Information.

BANZEL® is available by prescription only.

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.

The information contained herein is provided for educational purposes only and is not intended to replace discussions with a healthcare professional. All decisions regarding patient care must be made with a healthcare professional, considering the unique characteristics of the patient.

This site is intended for residents of the United States only. Any products discussed herein may have different product labeling in different countries. 

BANZEL® is a registered trademark used by Eisai under license from Eisai R & D Management Co., Ltd.

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