Medical Information Enquiry Form

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    Does this enquiry relate to an adverse event (AE) that has been experienced with an Eisai product? *
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    Privacy Notice

    By completing and submitting this form, you are making an unsolicited enquiry or request for medical information about an Eisai product. Your enquiry or request will be shared with Eisai’s Medical Information Department and partner in your region and will be added to Eisai’s medical information database. If your enquiry relates to an adverse event, your enquiry will also be shared with Eisai’s Pharmacovigilance Team and partner in your region. Eisai’s Medical Information Department or Pharmacovigilance Team, or Eisai’s partner in your region may contact you to discuss your enquiry or request, using the contact details that you provide in this form.

    We may share your enquiry or request including your personal data with our affiliates and partners within and outside of the European Economic Area (EEA) for the purpose described above. Where the transfer is made to our affiliates and partners outside of the EEA, we will ensure that appropriate safeguards for such transfer are in place in accordance with legal requirements.

    Eisai will process your personal data in accordance with the General Data Protection Regulation (GDPR). The legal bases for this processing of your personal data are Eisai’s legitimate business interests (in relation to responding to requests for medical information) or compliance with a legal obligation (in relation to the reporting of safety and quality issues of Eisai’s product). Further information about how Eisai processes your personal data, and your rights in relation to your personal data, is available in Eisai’s privacy statement which is available at If you have any questions about Eisai’s Privacy Statement or would like to contact our Data Protection Officer, please email us at