The Eisai Assistance Program can provide information to patients and healthcare professionals about coverage for HALAVEN® and programs to help patients afford their medication. Depending on your financial situation and clinical status, resources may be available to help with patient’s costs for HALAVEN®.
The Eisai Assistance Program can also provide information about the HALAVEN® Patient Assistance Program which provides support to patients who need assistance paying for HALAVEN®. This program provides HALAVEN® at no cost to financially needy patients who meet program eligibility criteria.
The HALAVEN $0 Co-Pay Program assists commercially insured HALAVEN patients with their HALAVEN cost-share (copayments and coinsurances). The HALAVEN $0 Co-Pay Program provides up to $18,000 per year to assist with out-of-pocket costs for HALAVEN®.
Step 1: Submit a completed enrollment form signed by both you and your physician.
Step 2: If you are eligible you will be sent a Welcome Letter and a card. This card should be given to your providers’ office so that it can be used to process the appropriate payment.
Step 3: Fax the Explanation of Benefits (EOB) or detailed specialty Pharmacy Receipt for the Halaven claim to 844-745-2350. The following information should be included:
Step 4: If your claim is approved, the appropriate funding based on the your out of pocket costs will be loaded onto the your card and a confirmation letter will be sent to you and your provider
Commercially insured patients will pay no more than $0. Maximum benefit paid by Eisai Inc. will be $18,000 per year. Depending on your insurance plan, you could have additional financial responsibility for any amounts over Eisai's maximum liability.
For questions about the savings program, please call 1-866-61-EISAI (1-866-613-4724).
Good toward the purchase of HALAVEN® prescriptions. No substitutions permitted. Not available to patients enrolled in state and federal healthcare programs, including Medicare, Medicaid, Medigap, VA, DoD or TRICARE. Offer available to MA residents through June 30, 2017. Offer only available to patients with private, commercial insurance. 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 HALAVEN®. Use of the card for any one purchase does not obligate the patient to make future purchases of HALAVEN® or any other product. This offer will expire November 20, 2019.
Eisai has created the HALAVEN® Patient Assistance Program for customers who need assistance paying for HALAVEN®. This program provides HALAVEN® at no cost to financially needy patients who meet program eligibility criteria.
Have your healthcare provider call the HALAVEN® Patient Assistance Program at 1-866-61-EISAI (1-866-613-4724) to determine eligibility. The hours of operation are 8 AM to 8 PM ET, Monday through Friday.
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
Who is HALAVEN® (eribulin mesylate) injection for?
HALAVEN® is a prescription medicine used to treat adults with breast cancer that has spread to other parts of the body, and who have already received other types of anticancer medicines after the cancer has spread.
HALAVEN® is also for adults with liposarcoma that cannot be treated with surgery or that has spread to other parts of the body, and who have received treatment with a certain type of anticancer medicine.
HALAVEN® can cause serious side effects, including:
Before you receive HALAVEN®, tell your health care provider about all of your medical conditions, including if you
Tell your health care provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
HALAVEN® can cause changes in your heartbeat (called QT prolongation). This can cause irregular heartbeats. Your health care provider may do heart monitoring (electrocardiogram or ECG) or blood tests during your treatment with HALAVEN® to check for heart problems.
The most common side effects of HALAVEN® in adults with breast cancer include low white blood cell count (neutropenia), low red blood cell count (anemia), weakness or tiredness, hair loss (alopecia), nausea, and constipation.
The most common side effects of HALAVEN® in adults with liposarcoma include tiredness, nausea, hair loss (alopecia), constipation, stomach pain, and fever.
Your health care provider will do blood tests before and during treatment while you are taking HALAVEN®. The most common changes to blood tests in adults with liposarcoma include low white blood cell count (neutropenia) and decreased blood levels of potassium or calcium.
For more information about HALAVEN®, talk to your doctor or see full prescribing information.
HALAVEN® is available by prescription only.
The information contained herein is provided for educational purposes only and is not intended to replace discussions with a health care professional. All decisions regarding patient care must be made with a health care 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.
HALAVEN® is a registered trademark used by Eisai under license from Eisai R & D Management Co., Ltd.