Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  

Eisai Assistance Program (Belviq)

This program provides brand name medications at no or low cost

Provided by: Eisai, Inc.

TEL: Closed Program

Languages Spoken:

English, Spanish, Others By Translation Service


Patient Assistance Applications


Generic Name Medications


Eligibility Requirements   

Insurance Status May have insurance
Those with Part D Eligible? Yes
Income At or below 150% of FPL
Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
US Residency Required? Must reside in the US, Puerto Rico or the USVI


Obtaining Call, download or apply online
Receiving Complete online or by phone
Returning Fax, mail or via Online Portal
Doctor's Action Give prescription to patient or Fax in prescription
Applicant's Action Complete section and sign
Decision Communicated
Decision Timeframe


Sent To
Delivery Time
Refill Process
Re-application New application every 12 months

Additional Information

Closed Program

For more information please visit

Eisai also offers a Savings Card Program to use at other pharmacies (restrictions apply). For information please visit

Updated February 18, 2020