Received an invoice? … As part of the Alexion OneSource suite of services, a financial support program is now available for eligible patients. ULTOMIRIS is not used in treating people with Shiga toxin E. coli related hemolytic uremic syndrome (STEC-HUS). Patient Assistance Programs. If you would like to speak to someone directly, please call 1-877-505-6986 1-877-505-6986. As with PACE, PA PAP pays providers via EFT and distributes a separate PA Patient Assistance Program Remittance Advice. Need help paying for Pfizer medicines? Tell your doctor about any side effect that bothers you or that does not go away. Alexion has agreed to pay $13 million to resolve the government’s allegations. Only need to present this card to participating pharmacy to get discount on Soliris prescription. This will help them diagnose and treat you quickly. Under the Soliris REMS, prescribers must enroll in the program. For treatment of atypical-HUS in adults and children 1 month of age and older. No membership fees apply . For additional assistance, call SYNAGIS CONNECT™ 1-833-SYNAGIS (1-833-796-2447) Monday through Friday 8:00 am to 8:00 pm EST. SOLIRIS, ALEXION, the Alexion logo, and the OneSource logo are registered trademarks of Alexion Pharmaceuticals, Inc., and OneSource is a trademark of Alexion Pharmaceuticals, Inc. It is not known if ULTOMIRIS will harm your unborn baby or if it passes into your breast milk. Half-life of eculizumab is 11.25-17.25 days. Also read: Pylera Copay Card. The Co-pay Card will be accepted only at participating pharmacies. Physicians must discuss the benefits and risks of Soliris therapy with patients and provide them with a patient information brochure and a patient safety card. This site can help you enroll in the co-pay program and activate or replace your co-pay coupon card. OneSource™ team members act as a bridge between you, your staff, and your patients to help support and facilitate your treatment plan. It is important to show this card to any doctor or nurse who treats you. If you had a meningococcal vaccine in the past, you might need additional vaccination. Description of Services . You must also meet financial criteria. Your doctor will give you a Patient Safety Card about the risk of meningococcal infection. The enrollment form can be found at www.AlexionOneSource.com/CoPayForm. Get more information to find out if it could be right for you. Soliris eculizumab aHUS 300 mg vials 25682-0001-01 4 vials/120 ml MG/NMOSD 300 mg vials 25682-0001-01 4 vials/120ml PNH 300 mg vials 25682-0001-01 3 vials/90ml . The HUMIRA Complete Savings Card may reduce your cost for HUMIRA to as little as $5 a month, every month. Before you can receive ULTOMIRIS, your doctor must: enroll in the ULTOMIRIS REMS program; counsel you about the risk of meningococcal infection; give you information and a Patient Safety Card about the symptoms and your risk of meningococcal infection (as discussed above); and make sure that you are vaccinated with a meningococcal vaccine, and if needed, get revaccinated with the meningococcal vaccine. Enrollment in the Soliris REMS program and additional information are available by telephone: 1-888-SOLIRIS (1-888-765-4747) or at www.solirisrems.com. – – – Co-contributors: Jeroen van Meijgaard, PhD, Jennifer Tran, PharmD, and Tori Marsh, MPH. Alexion is a global biopharmaceutical company focused on developing life-changing therapies for people living with rare disorders. Monitor patients for early signs of meningococcal infections and evaluate immediately if infection is suspected. By participating in the Program, participants acknowledge that they understand and agree to comply with the complete terms and conditions, available at alexiononesource.com/copay. There are currently no Manufacturer Promotions that we know about for this drug. Under the Soliris REMS, prescribers must enroll in the program [see Warnings and Precautions (5.2)]. Offer valid from 4/15/14 to 12/31/18. This will help them diagnose and treat you quickly. A few weeks ago I printed out one of your cards and used it on one of my medications because my co-pay went up and to my surprise instead of paying a $45.00 co-pay through my insurance, I ended up paying only $17.00 by just running it through the discount card! ULTOMIRIS Patient Safety Card; STEP 02. Soliris is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS). Meningococcal infections may quickly become life-threatening and cause death if not recognized and treated early. Do you want to continue? The patient's insurance must cover the qualifying medication that they are seeking assistance for. Not used in treating people with STEC-HUS. As a national advocacy program, Prescription Hope works directly with over 180 U.S. based pharmaceutical manufacturers and their pharmacy to obtain prescription medications at an affordable price. Now I will be comparing prices!" Do not receive ULTOMIRIS if you have a meningococcal infection or have not been vaccinated against meningococcal infection unless your doctor decides that urgent treatment with ULTOMIRIS is needed. These are not all the possible side effects of ULTOMIRIS. Siliq Solutions Instant Savings Program. SOLIRIS is a medicine that affects your immune system. Your doctor will give you a Patient Safety Card about the risk of meningococcal infection. Other knowledge Reviews For Prevpac. The Co-pay Card will be accepted only at participating pharmacies. ALEXION PHARMACEUTICALS Patient Assistance Program. Under the Soliris REMS, prescribers must enroll in the program. ULTOMIRIS increases your chance of getting serious and life-threatening meningococcal infections that may quickly become life-threatening and cause death if not recognized and treated early. Comply with the most current Advisory Committee on Immunization Practices (ACIP) recommendations for meningococcal vaccination in patients with complement deficiencies. NeedyMeds is the best source of information on organizations offering programs that help with costs associated with specific diagnoses. TERMS AND CONDITIONS. Interrupt Soliris infusion and institute appropriate supportive measures if signs of cardiovascular instability or respiratory compromise occur. The government alleged that Alexion made donations to a “Complement-Mediated Disease” (CMD) fund at a foundation to pay the Medicare copay obligations of patients taking Soliris and to induce those patients’ purchases of Soliris. Vaccination reduces, but does not eliminate, the risk of meningococcal infections. Additional financial assistance. You will receive communication from OneSource containing the CoPay ID number. SOLIRIS is only available through a program called the SOLIRIS REMS. Copay cards for patients. Alexion reserves the right to rescind, revoke, or amend this program without notice. Enrolling in this program may help you save on your out-of-pocket medication costs for SILIQ (brodalumab) injection, for subcutaneous use. If you have aHUS, your doctor will need to monitor you closely for at least 12 months after stopping treatment for signs of worsening aHUS or problems related to a type of abnormal clotting and breakdown of your red blood cells called thrombotic microangiopathy (TMA). Our discount and coupon prices are based on contracts between a pharmacy (or pharmacy purchasing group) and a Pharmacy Benefit Manager (PBM), who provides prices to us. One day I after suffering from extreme stomach pain and vomiting went to the emergency room. NULOJIX ® (belatacept) (in combination with basiliximab induction, mycophenolate mofetil [MMF], and corticosteroids) is indicated for prophylaxis of organ rejection in adults receiving a kidney transplant; Use NULOJIX only in patients who are Epstein-Barr virus (EBV) seropositive; Use of NULOJIX for prophylaxis of organ rejection in transplanted organs other than kidney has not been established Prescription Hope is not an insurance policy or discount drug program. Your risk of meningococcal infection may continue for several weeks after your last dose of SOLIRIS. References 1. If your pharmacy is unable to process your HUMIRA Complete Savings Card for instant savings, you may still be able to get HUMIRA for as little as $5 a month by receiving a rebate for the amount you paid out of pocket for your prescription. This Soliris Discount is similar to Buying Group Coupon. Yes ULTOMIRIS can cause serious side effects including infusion-related reactions. Soliris is indicated for the treatment of generalized myasthenia gravis (gMG) in adult patients who are anti-acetylcholine receptor (AChR) antibody positive. Home infusions may be an option for your ULTOMIRIS infusion if covered by your insurance plan. For help with the CAVERJECT IMPULSE $20 Co-Pay Card, call 1-866-300 … SOLIRIS increases your chance of getting serious and life-threatening meningococcal infections. HCP for physicians. HCP for physicians. Soliris ® (eculizumab), a complement inhibitor, is the first and only medication approved by the FDA to treat adults with neuromyelitis optica spectrum disorder (NMOSD) who are anti-aquaporin-4 (AQP4) antibody positive. Patient with Medicare Part D will be considered on a case by case basis. Copyright © 2020 Alexion Pharmaceuticals, Inc. All rights reserved. ULTOMIRIS may also increase the risk of other types of serious infections. Ultomiris offers may be in the form of a printable coupon, rebate, savings card, trial offer, or free samples. Discontinue Soliris in patients who are undergoing treatment for serious meningococcal infections. Carry it with you at all times during treatment and for 8 months after your last ULTOMIRIS dose. Eligibility. Methodology. Is Prescription Hope an insurance policy or discount drug card? Talk to an MS One to One Nurse to learn more at 1‑855‑676‑6326 1-855-676-6326. Anime figures are at the heart of Japanese culture and our extensive franchise range covers figures from One Piece, Dragon Ball, Death Note and Bleach to … When your patient enrolls in the OneSource™ program, they will be assigned to a dedicated OneSource team member who can help them with: For more information about OneSource and all it offers, visit AlexionOneSource.com or call 888.765.4747. ET Headquarters: The Assistance Fund 4700 Millenia Blvd., Suite 410 SOLIRIS is only available through a program called the SOLIRIS REMS. This program is for patients with private or commercial insurance. SOLIRIS can lower the ability of your immune system to fight infections. Soliris 300 mg/30 mL single-use vials for injection: 25682-0001-xx VII. Boston, MA; Alexion Pharmaceuticals, Inc; June 2019. Alexion Complement Foundation. Fill out the form with patient information and fax to OneSource at 1-800-420-5150 or email to OneSource@alexion.com. Serious infections with Neisseria species (other than N. meningitidis), including disseminated gonococcal infections, have been reported. Most programs have income, age, and other eligibility requirements. Patients residing in Massachusetts, Minnesota, and Rhode Island are eligible for assistance with medication costs, but are not eligible for assistance with infusion costs. Immunize patients with meningococcal vaccines at least 2 weeks prior to administering the first dose of Soliris, unless the risks of delaying Soliris therapy outweigh the risk of developing a meningococcal infection. Guidelines for the diagnosis and monitoring of paroxysmal nocturnal hemoglobinuria and related disorders by flow cytometry. About GoodRx Prices and Soliris Coupons GoodRx‘s cash prices are based on multiple sources, including published price lists, purchases, claims records, and data provided by pharmacies. Use caution when administering Soliris to patients with any systemic infection. Sign up to stay informed about SOLIRIS® (eculizumab). This link will take you to a different site that is owned and operated by an independent third party to which this Privacy Policy does not apply. Pfizer RxPathways connects eligible patients to a range of assistance programs to help them access their Pfizer prescriptions. * Get the Card Now. Phone: (855) 845-3663 Patient Fax: (833) 865-3757 Business Fax: (855) 430-0590 Monday - Friday, 9 a.m. - 6 p.m. ALEXION PHARMACEUTICALS Patient Assistance Program. Great but recommended not to be taken with food I have had stomach issues for the past 4 years. Jonathan Gardner ... Alexion helped create a fund narrowly crafted to support its expensive ultra-rare disease drug Soliris, the Justice Department said.