Clinical information guide - lenvima.com

HIGHLIGHTS OF PRESCRIBING INFORMATION - …

FULL PRESCRIBING INFORMATION: CONTENTS* 1 INDICATIONS AND USAGE 1.1 Differentiated Thyroid Cancer 1.2 Renal Cell Carcinoma 1.3 Hepatocellular Carcinoma

  Information, Prescribing, Prescribing information

OR Eisai Assistance Program 1-866-61-EISAI …

If signed by legal representative, describe the nature of his/her relationship with the patient: Name of Patient Name of Legal Representative Signature

HIGHLIGHTS OF PRESCRIBING INFORMATION

Hepatocellular Carcinoma (HCC) • For the first-line treatment of patients with unresectable hepatocellular carcinoma (HCC). (1.3) Endometrial Carcinoma (EC) • In combination with pembrolizumab, for the treatment of patients with advanced endometrial carcinoma (EC) that is not microsatellite

  Treatment, Hepatocellular carcinoma, Hepatocellular, Carcinoma, For the treatment

Restrictions and limitations apply.* Copay

Dear Pharmacist: I have given my commercially insured patient a Mayne Pharma Patient Savings Card for his/her prescription. It is …

  Insured, Commercially, Commercially insured

Injectafer Savings Program Check Fax Request Form

PP -US IN 0382 10/17 Injectafer Savings Program Check Fax Request Form Please fax the Explanation of Benefits (EOB) form from the …

  Programs, Request, Savings, Check, Injectafer savings program check fax request, Injectafer

Injectafer Savings Program Eligibility Attestation …

PP-US-IN-0381 10/17 Injectafer Savings Program Eligibility Attestation Form I, _____ (Print Name), certify that on _____&_____

  Programs, Form, Eligibility, Savings, Attestation, Injectafer, Injectafer savings program eligibility attestation, Injectafer savings program eligibility attestation form

ELIGIBLE PATIENTS CAN SAVE ON THEIR …

*Subject to eligibility rules below; restrictions apply. *Subject to eligibility rules below; restrictions apply. ELIGIBLE PATIENTS CAN SAVE*. …

  Patients, Eligible, Eligible patients

FREE TRIAL OFFER* FOR ELIGIBLE PATIENTS

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch or call 1-800-FDA-1088. If you are without prescription coverage and cannot afford ...

  Patients, Eligible, For eligible patients

for eligible commercially insured patients Pay $5 …

Pay $5 per injection * Savings Program for eligible commercially insured patients *$20,000 maximum program benefit per calendar year. Terms expire at the end of each

  Patients, Eligible, Insured, Commercially, For eligible commercially insured patients pay, For eligible commercially insured patients

for eligible commercially insured patients $10 co …

Please read the full Prescribing Information , including Boxed Warnings, and Medication Guide for XARELTO®, and discuss any questions you have with your doctor.

  Patients, Eligible, Insured, Commercially, For eligible commercially insured patients