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This program provides brand name medications at no or low cost.
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| Pharmaceutical Company |
Eisai Inc |
| Program Name |
Eisai Oncology Reimbursement Assistance Program |
| Program Address |
PO Box 4133
Gaithersburg, MD 20885-4133
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| Phone Number |
866-613-4724
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| Fax Number |
866-573-4724 |
| Medications on Program |
None |
| Application Forms |
Not Applicable |
On-line Application
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No on-line application available at this time |
| Web Site |
No link available. |
| Eligibility Guidelines and Notes |
The patient must have no prescription coverage for the requested medication and meet income guidelines that are not disclosed. Medical diagnosis necessary for this program is not specified. US residency requirements are
not specified. This program is handled on a case-by-case basis. Patients in need should contact them. Patients who are eligible for Medicare Part D but did not enroll are not eligible for this program.
There is also the Ontak Access Resource program that will credit the doctors for the medication if the patient is accepted.
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| Application Process |
With the patient's permission, anyone concerned can call for an application. The application can be either faxed or mailed out upon request. The completed application can be faxed or mailed back.
Both the patient and the health care professional are notified in writing of acceptance or denial. The decision is usually made within 48 hours.
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| Application Requirements |
The doctor must fill out a section, sign the application and attach a prescription. The patient must fill out a section and sign the application.
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| Program Details |
The medication is sent to the doctor's office. The company contacts the doctor to arrange for refills. Each medication has different guidelines for renewal.
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| Last Updated |
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