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Restrictions and Conditions of Use:

Voucher

  • Limited to 1 BELVIQ® free trial voucher redemption per person. Not valid for refills. No substitutions permitted.
  • No purchase or co-pay required.
  • Not valid through mail-order pharmacies.
  • Claims for any product dispensed pursuant to this voucher shall not be submitted to any public (e.g., Medicare, Medicaid) or private (e.g., insurance company) payer for reimbursement.
  • Federal law prohibits the selling, purchasing, trading, or counterfeiting of this voucher. Such activities may result in imprisonment of 10 years, fines up to $250,000, or both.
  • Void outside the USA and where prohibited by law.
  • Eisai, Inc. reserves the right to rescind, revoke, or amend this offer at any time without notice.
  • Must be 18 years of age or older.
  • Voucher accepted at most major pharmacies.
  • Voucher available to Medicare and Medicaid patients, but claims shall not be submitted to any public (e.g., Medicare, Medicaid) or private (e.g., insurance company) payer for reimbursement.
  • Other restrictions apply.

Savings Card

  • Limited to one prescription per patient for any 30-day period. Save your card to reuse each month up to the expiration date.
  • Good toward the purchase of BELVIQ® prescriptions for up to 12 uses. No substitutions permitted.
  • Not available to individuals enrolled in federally subsidized healthcare programs that cover prescription drugs, including Medicare, Medicaid, TRICARE, or any similar federal or state programs.
  • Not valid for BELVIQ® prescription reimbursed in full by any third-party payer.
  • 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 your Savings Card; such activities may result in imprisonment of 10 years, fines of $250,000, or both.
  • Void outside the USA and where prohibited by law.
  • Eisai Inc. reserves the right to rescind, revoke, or amend this offer without notice at any time.
  • Must be 18 years of age or older.
  • 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 or 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 BELVIQ®. Use of the Card for any one purchase does not obligate the patient to make future purchases of BELVIQ® or any other product.
  • Other restrictions apply.

If you have questions about the program rules or require additional information, please call 1-800-657-7613.

Terms of Information Use

Please be advised that the personal information you provide will be used to satisfy your request to receive or activate a trial voucher or savings card. The marketer of BELVIQ, Eisai Inc. (“Eisai” or “we”), operates this website and our Privacy Policy will govern the collection, use, disclosure and retention of the information you provide here. Please do not submit any personal information unless you have read and agree with the terms of that Privacy Policy. Consistent with the Privacy Policy, we and our service providers may use the personal information you provide to contact you and send you communications, including about products or services that may interest you. At any time, you may request to be removed from the list to receive such communications by calling 1-855-BELVIQ1 (1-855-235-8471). By clicking “submit” below, you agree that you have read, understand, and agree to these conditions.

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