Good toward the purchase of prescriptions for BELVIQ® (lorcaserin HCI) CIV or BELVIQ XR® (lorcaserin HCI) CIV for up to 13 uses per year. Limited to 1 prescription per patient for any 30-day period. For patients with commercial insurance that covers the product, the patient pays the first $30 for BELVIQ XR or $40 for BELVIQ, and then Eisai Inc. will provide no more than $160 off the patient's out-of-pocket costs per commercially insured, covered prescription. For patients paying cash who have commercial insurance that does not cover the product, Medicare Part D, TRICARE, or are uninsured, Eisai will provide no more than $195 off the patient's cash price per 30 day fill.Save this card to reuse each month up to the expiration date or program discontinuation. No substitutions permitted.
If you have any questions about the program rules or require additional information, please call 1-855-BELVIQ1 (1-855-235-8471). Questions about coverage? Call 1-866-61-EISAI (1-866-613-4724).
Financial assistance is available. For more about our Patient Assistance Program for those in financial need, click here.
BELVIQ/BELVIQ XR is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of 30 kg/m2 or greater (obese), or 27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbid condition (e.g., hypertension, dyslipidemia, type 2 diabetes).
Limitations of Use:
BELVIQ®/BELVIQ XR® is a federally controlled substance (CIV) because it may be abused or lead to dependence.
For more information about BELVIQ®/BELVIQ XR®, see full Prescribing Information.