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Important Safety Information

Prescribing Information

BANZEL.com/hcp

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

Monday - Friday, 9 am to 5 pm ET

BILLING & CODINGCOVERAGE POLICIESPATIENT SUPPORTDOCUMENTS & RESOURCES

Patient Support

Below you will find resources to help 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 billing, coding, coverage and financial assistance questions.

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*

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

*Eligible patients pay the first $25 and Eisai Inc. will pay up to $275 per month. Patient could have additional financial responsibility depending on patient's insurance plan. For questions, please call 1-855-EISAI-4-U (1-855-347-2448).

Terms and Conditions

Good toward the purchase of BANZEL® prescriptions. Eligible patients pay the first $25 and Eisai Inc. will pay up to a maximum of $275 per month. No substitutions permitted. Save the Savings 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. Not valid for BANZEL® prescription reimbursed in full by any third-party payer. May not be combined with any other discount or offer. Federal law prohibits the selling, purchasing, trading, or counterfeiting of this card. Void outside the USA and where prohibited by law. Eisai Inc. reserves the right to rescind, revoke, or amend this offer without notice at any time. You must be 18 years or older to use the card for yourself or a minor. Patients and pharmacies are responsible for disclosing to insurance carriers the redemption and value of the Savings Card and complying with any other conditions imposed by insurance carriers, third-party payers, and applicable law on the redemption. The value of the Savings Card is not contingent on any prior or future purchases. This card may not be accepted at all pharmacies. This card is not an insurance program. No membership fees. This offer will expire July 31, 2021.

The Rx Outreach Patient Assistance Program®*

Rx Outreach is an independent non-profit pharmacy making medications affordable for eligible patients. 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. The Rx Outreach Program may be able to assist eligible Banzel patients.

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).

*This program is not offered by Eisai.

Find Information on Medicaid Coverage

Learn about coverage alternatives for BANZEL® including Medicaid coverage
BANZEL® COVERAGE POLICIES

BANZEL® Offers Dosing Options

Learn about BANZEL® Dosing Options and Sample Titration Schedules
FIND DOSING INFORMATION

Related Documents

BANZEL® Eisai Assistance Program Benefit Investigation Form >

Rx Outreach Enrollment Form >

 

BANZEL® Sample Letter of Appeal >

BANZEL® Sample Letter of Medical Necessity >

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 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 and Precautions:

  • Suicidal behavior and ideation: 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.
  • Central nervous system reactions: 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.
  • QT shortening: 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.
  • Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Multi-organ hypersensitivity syndrome, also known as DRESS, 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 DRESS 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.
  • Withdrawal of AEDs: 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 3 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 (12% 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

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.

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