Insurance Coverage Information
HALAVEN® is generally covered by Insurance Companies, Medicare and Medicaid. Coverage may vary based on the specific type of insurance you have and your Healthcare Provider. Ask your Healthcare Provider about how your insurance will cover HALAVEN®.
Eisai may be able to offer financial assistance to eligible patients who can’t afford HALAVEN®. Talk to your Healthcare Provider about what assistance options may be available to you. The Eisai Assistance Program can assist you with understanding your options and can be reached at 1-866-61-EISAI or 1-866-613-4724.
Commercial Insurance
Commercial insurance companies include organizations such as health maintenance organization (HMO) plans, managed care organizations, indemnity plans and others. Many of these provide coverage for HALAVEN® (eribulin mesylate) injection. However, specific coverage requirements and limits depend on a patient’s benefits and will vary based on your plan type and healthcare provider. Contact your Healthcare Provider to understand what your coverage for HALAVEN® will be.
Medicare
Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease. Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services. Part B should cover your use of HALAVEN®. Contact your Healthcare Provider for assistance in understanding how Medicare may cover your HALAVEN® treatments.
Medicaid
Medicaid is a joint federal and state program that helps with medical costs for some people with limited income and resources. Each state sets its own coverage and eligibility rules for its Medicaid program. HALAVEN® (eribulin mesylate) injection is eligible for coverage under most state Medicaid programs. However, coverage and patient out of pocket costs will vary from state to state. Contact your Healthcare Provider for assistance in determining how your state Medicaid plan will cover HALAVEN®.
Getting Coverage
Understanding your insurance coverage is the first step in getting your treatments covered. In most cases, this is going to start with your healthcare provider contacting your insurance company. Once your coverage has been established you can explore your alternatives. If your insurance covers most of your treatment costs, there may be assistance paying the copays on your medications. If do you not have coverage, you may be eligible for government assistance such as Medicare or Medicaid. If you do not qualify for these programs Eisai offers a Patient Assistance Program that may help. Contact your Healthcare Provider to start understanding your coverage needs and determine eligibility for assistance.
Do You Need Financial Assistance?
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.
Indication
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.
Important Safety Information
What safety information do I need to know about HALAVEN®?
HALAVEN® can cause serious side effects, including:
- Low white blood cell count (neutropenia). This can lead to serious infections that could lead to death. Your health care provider will check your blood cell counts. Call your health care provider right away if you develop fever (temperature above 100.5°F), chills, cough, or burning or pain when you urinate, as any of these can be symptoms of infection
- Numbness, tingling, or pain in your hands or feet (peripheral neuropathy). Peripheral neuropathy is common with HALAVEN® and sometimes can be severe. Tell your health care provider if you have new or worsening symptoms of peripheral neuropathy
- Your health care provider may delay or decrease your dose or stop treatment with HALAVEN® if you have side effects
Before you receive HALAVEN®, tell your health care provider about all of your medical conditions, including if you
- have liver or kidney problems
- have heart problems, including a problem called congenital long QT syndrome
- have low potassium or low magnesium in your blood
- are pregnant or plan to become pregnant. HALAVEN® can harm your unborn baby. Tell your health care provider right away if you become pregnant or think you are pregnant during treatment with HALAVEN®. Females who are able to become pregnant should use an effective form of birth control during treatment with HALAVEN® and for at least 2 weeks after the final dose of HALAVEN® and males should use an effective form of birth control when having sex with female partners who are able to become pregnant during treatment with HALAVEN® and for 3 1/2 months (14 weeks) after the final dose of HALAVEN®
- are breastfeeding or plan to breastfeed. It is not known if HALAVEN® passes into your breast milk. Do not breastfeed during treatment with HALAVEN® and for 2 weeks after the final dose of HALAVEN®
Tell your health care provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
What are the possible side effects of HALAVEN®?
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.
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 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.
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