Eisai Assistance Program
The Eisai Assistance Program offers access and reimbursement support, including:
Prior authorization information
Financial assistance information via the HALAVEN $0 Co-Pay Program (see below for more information)
The HALAVEN Patient Assistance Program for eligible patients who need help paying for HALAVEN (see below for more information)
To determine if your patients are eligible, download the HALAVEN Eisai Assistance Program Enrollment Form or call 1-866-613-47241-866-613-4724. Hours of operation are Monday through Friday, 8 AM to 5 PM ET.
HALAVEN® $0 Co-Pay Program
With the HALAVEN $0 Co-Pay Program, eligible commercially insured patients could pay as little as $0 out of pocket for each prescription.
Eisai will pay up to $18,000 per year to assist with the out-of-pocket costs for HALAVEN. Depending on the insurance plan, a patient could have additional financial responsibility for any amounts over Eisai’s maximum liability.
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
TERMS AND CONDITIONS
Good toward the purchase of HALAVEN prescriptions
No substitutions permitted
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 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 card and complying with any other conditions imposed by insurance carriers on third-party payers
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 August 31, 2023
HALAVEN® Patient Assistance Program
The Eisai Assistance Program provides HALAVEN at no cost to patients in need who meet program eligibility criteria.*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.
HALAVEN® is a microtubule inhibitor indicated for the treatment of patients with:
Metastatic breast cancer who have previously received at least two chemotherapeutic regimens for the treatment of metastatic disease. Prior therapy should have included an anthracycline and a taxane in either the adjuvant or metastatic setting.
Unresectable or metastatic liposarcoma who have received a prior anthracycline-containing regimen.
HALAVEN® Important Safety Information
Warnings and Precautions
Neutropenia: Severe neutropenia (ANC < 500/mm3) lasting > 1 week occurred in 12% of patients with mBC and liposarcoma or leiomyosarcoma. Febrile neutropenia occurred in 5 % of patients with mBC and 2 patients (0.4%) died from complications. Febrile neutropenia occurred in 0.9% of patients with liposarcoma or leiomyosarcoma, and fatal neutropenic sepsis occurred in 0.9% of patients. Patients with mBC with elevated liver enzymes >3 × ULN and bilirubin >1.5 × ULN experienced a higher incidence of Grade 4 neutropenia and febrile neutropenia than patients with normal levels. Monitor complete blood cell counts prior to each dose, and increase the frequency of monitoring in patients who develop Grade 3 or 4 cytopenias. Delay administration and reduce subsequent doses in patients who experience febrile neutropenia or Grade 4 neutropenia lasting >7 days.
Peripheral Neuropathy: Grade 3 peripheral neuropathy occurred in 8% of patients with mBC (Grade 4=0.4 %) and 22% developed a new or worsening neuropathy that had not recovered within a median follow-up duration of 269 days (range 25-662 days). Neuropathy lasting >1 year occurred in 5% of patients with mBC. Grade 3 peripheral neuropathy occurred in 3.1% of patients with liposarcoma and leiomyosarcoma receiving HALAVEN® and neuropathy lasting more than 60 days occurred in 58% (38/65) of patients who had neuropathy at the last treatment visit. Patients should be monitored for signs of peripheral motor and sensory neuropathy. Withhold HALAVEN® in patients who experience Grade 3 or 4 peripheral neuropathy until resolution to Grade 2 or less.
Embryo-Fetal Toxicity: HALAVEN® can cause fetal harm when administered to a pregnant woman. Advise females of reproductive potential to use effective contraception during treatment with HALAVEN® and for at least 2 weeks following the final dose. Advise males with female partners of reproductive potential to use effective contraception during treatment with HALAVEN® and for 3.5 months following the final dose.
QT Prolongation: Monitor for prolonged QT intervals in patients with congestive heart failure, bradyarrhythmias, drugs known to prolong the QT interval, and electrolyte abnormalities. Correct hypokalemia or hypomagnesemia prior to initiating HALAVEN® and monitor these electrolytes periodically during therapy. Avoid in patients with congenital long QT syndrome.
In patients with mBC receiving HALAVEN®, the most common adverse reactions (≥25%) were neutropenia (82%), anemia (58 %), asthenia/fatigue (54%), alopecia (45%), peripheral neuropathy (35%), nausea (35%), and constipation (25%). Febrile neutropenia (4%) and neutropenia (2%) were the most common serious adverse reactions. The most common adverse reaction resulting in discontinuation was peripheral neuropathy (5%).
In patients with liposarcoma and leiomyosarcoma receiving HALAVEN®, the most common adverse reactions (≥25%) reported in patients receiving HALAVEN® were fatigue (62%), nausea (41%), alopecia (35%), constipation (32%), peripheral neuropathy (29%), abdominal pain (29%), and pyrexia (28%). The most common (≥5%) Grade 3-4 laboratory abnormalities reported in patients receiving HALAVEN® were neutropenia (32%), hypokalemia (5.4%), and hypocalcemia (5%). Neutropenia (4.9%) and pyrexia (4.5%) were the most common serious adverse reactions. The most common adverse reaction resulting in discontinuation were fatigue and thrombocytopenia (0.9% each).
Use in Specific Populations
Lactation: Because of the potential for serious adverse reactions in breastfed infants from eribulin mesylate, advise women not to breastfeed during treatment with HALAVEN® and for 2 weeks after the final dose.
Hepatic and Renal Impairment: A reduction in starting dose is recommended for patients with mild or moderate hepatic impairment and/or moderate or severe renal impairment.
For more information about HALAVEN®, please see full Prescribing Information.