How can I receive help paying for HALAVEN®?

HALAVEN® $0 CO-PAY PROGRAM

With the HALAVEN $0 Co-Pay Program, you 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 your insurance plan, you could have additional financial responsibility for any amounts over Eisai’s maximum liability.

ELIGIBILITY CRITERIA & TERMS AND CONDITIONS

ELIGIBILITY CRITERIA

  • 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

DOWNLOAD THE FORM  arrow

To learn more about the HALAVEN $0 Co-Pay Program

Call 1.855.EISAI.4U (1.855.347.2448)
Monday–Friday, 8 am to 5 pm, ET