EISAI ASSISTANCE PROGRAM
The Eisai Assistance Program offers access and reimbursement support, including:
- Benefits verification
- Prior authorization information
- Appeal information
- Financial assistance information via the LENVIMA® (lenvatinib) $0 Co-pay Program (see below for more information)
- The LENVIMA Patient Assistance Program for patients who need help paying for LENVIMA. This program provides LENVIMA at no cost to uninsured and financially burdened patients who meet the program eligibility criteria
LENVIMA $0 CO-PAY PROGRAM
With the LENVIMA $0 Co-pay Program, you could pay as little as $0 out of pocket for each prescription.
Eisai will pay up to $40,000 per year to assist with the out-of-pocket costs for LENVIMA. Depending on your insurance plan, you could have additional financial responsibility for any amounts over Eisai’s maximum liability.
To learn more, speak to your pharmacist.
ELIGIBILITY CRITERIA & TERMS AND CONDITIONS
- Not available to patients enrolled in state or federal healthcare programs, including Medicare, Medicaid, Medigap, VA, DoD, or TRICARE
- Offer only available to patients with private, commercial insurance
- Program is not valid for cash-paying customers
- Patients must be 18 years or older to use this card for themselves or a minor
TERMS AND CONDITIONS
- Good toward the purchase of LENVIMA prescriptions
- The LENVIMA $0 Co-pay Program provides up to a maximum of $40,000 per year to assist with the out-of-pocket costs for LENVIMA
- Depending on the insurance plan, a patient could have additional financial responsibility for any amounts over Eisai’s maximum liability
- No substitutions permitted
- Not valid for LENVIMA prescriptions reimbursed in full by any third-party payer
- Save this information for reuse with each prescription
- 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 US 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 program and complying with any other conditions imposed by insurance carriers, third-party payers, and applicable law on the redemption
- The value of this program 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 March 31, 2023
LENVIMA PATIENT ASSISTANCE PROGRAM
The LENVIMA Patient Assistance Program provides LENVIMA at no cost to patients in need who meet program eligibility criteria.*
To determine if you are eligible, download the LENVIMA Eisai Assistance Program Enrollment Form or call 1-866-61-EISAI (1-866-613-4724)1-866-61-EISAI (1-866-613-4724). Hours of operation are Monday through Friday, 8 AM to 8 PM ET.DOWNLOAD THE FORM
Eisai cannot guarantee payment of any claim. Coding, coverage, and reimbursement may vary significantly by payer, plan, patient, and setting of care. Actual coverage and reimbursement decisions are made by individual payers following the receipt of claims. For additional information, customers should consult with their payers 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.
What is LENVIMA?
LENVIMA is a prescription medicine that is used to treat certain kinds of cancer.
LENVIMA is used by itself to treat differentiated thyroid cancer (DTC), a type of thyroid cancer that can no longer be treated with radioactive iodine and is progressing
LENVIMA is used along with another medicine called everolimus to treat advanced renal cell carcinoma (RCC), a type of kidney cancer, after one course of treatment with another anti-cancer medicine
- LENVIMA is used by itself as the first treatment for a type of liver cancer called hepatocellular carcinoma (HCC) when it cannot be removed by surgery.
It is not known if LENVIMA is safe and effective in children.
IMPORTANT SAFETY INFORMATIONLENVIMA may cause serious side effects, including:
high blood pressure (hypertension): High blood pressure is a common side effect of LENVIMA and can be serious. Your blood pressure should be well controlled before you start taking LENVIMA. Your healthcare provider should check your blood pressure regularly during treatment with LENVIMA. If you develop blood pressure problems, your healthcare provider may prescribe medicine to treat your high blood pressure
heart problems: LENVIMA can cause serious heart problems that may lead to death. Call your healthcare provider right away if you get symptoms of heart problems, such as shortness of breath or swelling of your ankles
problem with blood clots in your blood vessels (arteries): Get emergency medical help right away if you get any of the following symptoms: severe chest pain or pressure; pain in your arms, back, neck, or jaw; shortness of breath; numbness or weakness on one side of your body; trouble talking; sudden severe headache; sudden vision changes
liver problems: LENVIMA may cause liver problems that may lead to liver failure and death. Your healthcare provider will check your liver function before and during treatment with LENVIMA. Tell your healthcare provider right away if you have any of the following symptoms: your skin or the white part of your eyes turns yellow (jaundice); dark “tea-colored” urine; light-colored bowel movements (stools); feeling drowsy, confused or loss of consciousness
kidney problems: Kidney failure, which can lead to death, has happened with LENVIMA treatment. Your healthcare provider should do regular blood tests to check your kidneys
increased protein in your urine (proteinuria): Proteinuria is a common side effect of LENVIMA and can be serious. Your healthcare provider should check your urine for protein before and during your treatment with LENVIMA
diarrhea: Diarrhea is a common side effect of LENVIMA and can be serious. If you get diarrhea, ask your healthcare provider about what medicines you can take to treat your diarrhea. It is important to drink more water when you get diarrhea. Tell your healthcare provider or go to the emergency room, if you are unable to drink enough liquids and your diarrhea is not able to be controlled
an opening in the wall of your stomach or intestines (perforation) or an abnormal connection between two or more body parts (fistula): Get emergency medical help right away if you have severe stomach (abdomen) pain
changes in the electrical activity of your heart called QT prolongation: QT prolongation can cause irregular heartbeats that can be life threatening. Your healthcare provider will do blood tests before and during your treatment with LENVIMA to check the levels of potassium, magnesium, and calcium in your blood, and may check the electrical activity of your heart with an ECG
low levels of blood calcium (hypocalcemia): Your healthcare provider will check your blood calcium levels during treatment with LENVIMA and may tell you to take a calcium supplement if your calcium levels are low
a condition called Reversible Posterior Leukoencephalopathy Syndrome (RPLS): Call your healthcare provider right away if you get severe headache, seizures, weakness, confusion, or blindness or change in vision
bleeding: LENVIMA may cause serious bleeding problems that may lead to death. Tell your healthcare provider if you have any signs or symptoms of bleeding during treatment with LENVIMA, including severe and persistent nose bleeds; vomiting blood; red or black (looks like tar) stools; blood in your urine; coughing up blood or blood clots; heavy or new onset vaginal bleeding
change in thyroid hormone levels: Your healthcare provider should check your thyroid hormone levels before starting and every month during treatment with LENVIMA
wound healing problems: Wound healing problems have happened in some people who take LENVIMA. Tell your healthcare provider if you plan to have any surgery before or during treatment with LENVIMA.
You should stop taking LENVIMA at least 1 week before planned surgery
Your healthcare provider should tell you when you may start taking LENVIMA again after surgery
severe jaw bone problems (osteonecrosis): Severe jaw bone problems have happened in some people who take LENVIMA. Certain risk factors such as taking a bisphosphonate medicine or the medicine denosumab, having dental disease, or an invasive dental procedure may increase your risk of getting jaw bone problems. Your healthcare provider should examine your mouth before you start and during treatment with LENVIMA. Tell your dentist that you are taking LENVIMA. It is important for you to practice good mouth care during treatment with LENVIMA. Tell your healthcare provider right away if you have any signs or symptoms of jaw bone problems during treatment with LENVIMA, including jaw pain, toothache, or sores on your gums and if you plan to have any dental procedures before or during treatment with LENVIMA.
You should stop taking LENVIMA at least 1 week before planned dental surgery or invasive dental procedures
Your healthcare provider should tell you when you may start taking LENVIMA again after dental procedures
The most common side effects of LENVIMA in people treated for thyroid cancer include tiredness, joint and muscle pain, decreased appetite, weight loss, nausea, mouth sores, headache, vomiting, rash, redness, itching, or peeling of your skin on your hands and feet, stomach (abdomen) pain, and hoarseness.
The most common side effects of LENVIMA in people treated for kidney cancer include tiredness, joint and muscle pain, decreased appetite, vomiting, nausea, mouth sores, swelling in your arms and legs, cough, stomach (abdomen) pain, trouble breathing, rash, weight loss, and bleeding.
The most common side effects of LENVIMA in people treated for liver cancer include tiredness, decreased appetite, joint and muscle pain, weight loss, stomach (abdomen) pain, rash, redness, itching, or peeling of your skin on your hands and feet, hoarseness, bleeding, change in thyroid hormone levels, and nausea.
LENVIMA may cause fertility problems in males and females. Talk to your healthcare provider if this is a concern for you.
These are not all the possible side effects of LENVIMA. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088 or visit www.fda.gov/medwatch.