The most frequently reported adverse reaction in gMG placebo-controlled clinical trial (≥10%) is: musculoskeletal pain. To be eligible for the Alexion OneSource CoPay Program a patient must: Patients who live in MA, MI, MN, or RI are not eligible to have their infusion-related costs covered by this program. Pfizer RxPathways connects eligible patients to a range of assistance programs to help them access their Pfizer prescriptions. Do you want to continue? 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. The Co-pay Card is not health insurance. Before you receive ULTOMIRIS, tell your doctor about all of your medical conditions, including if you: have an infection or fever, are pregnant or plan to become pregnant, and are breastfeeding or plan to breastfeed. If you have not been vaccinated and ULTOMIRIS therapy must be initiated immediately, you should also receive 2 weeks of antibiotics with your vaccinations. Other knowledge Reviews For Prevpac. At this current time we don´t have the eligibility information for … SOLIRIS is only available through a program called the SOLIRIS REMS. Generalized Myasthenia Gravis (gMG) Soliris is indicated for the treatment of generalized myasthenia gravis (gMG) in adult patients who are anti-acetylcholine receptor (AChR) antibody positive. Eligible patients may get up to $6000 per SYNAGIS season to assist with out-of-pocket costs for SYNAGIS (paying as little as $0 per dose). 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. ULTOMIRIS is a medicine that affects your immune system and can lower the ability of your immune system to fight infections. Soliris [package insert]. This will help them diagnose and treat you quickly. Please enter your information below to receive updates: *Required field. 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. a The mean (SD) terminal elimination half-life and clearance of ravulizumab-cwvz in patients with PNH are 49.7 (8.9) days and 0.08 (0.022) L/day, respectively. HCP for physicians. If Soliris must be initiated immediately in an unvaccinated patient, administer meningococcal vaccine(s) as soon as possible and provide 2 weeks of antibacterial drug prophylaxis. ALEXION PHARMACEUTICALS Patient Assistance Program. The Co-pay Card will be accepted only at participating pharmacies. 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. 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). Enrollment in the Soliris REMS program and additional information are available by telephone: 1-888-SOLIRIS … Soliris is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS). Under the Soliris REMS, prescribers must enroll in the program. Alexion OneSource CoPay Program Terms and Conditions The Alexion OneSource™ Copay Program (the “Program”) pays for eligible out-of-pocket medication and infusion costs associated with Soliris® (eculizumab) or ULTOMIRIS® (ravulizumab-cwvz) up to $15,000 US dollars per calendar year. Jonathan Gardner ... Alexion helped create a fund narrowly crafted to support its expensive ultra-rare disease drug Soliris, the Justice Department said. Meningococcal infections may quickly become life-threatening and cause death if not recognized and treated early. OneSource is a complimentary, personalized patient support program offered by Alexion and tailored to the specific needs of people living with aHUS, gMG, HPP, LAL-D, NMOSD and PNH. Your doctor will give you a Patient Safety Card about the risk of meningococcal infection. Your risk of meningococcal infection may continue for several weeks after your last dose of SOLIRIS. The Program is not valid for costs eligible to be reimbursed, in whole or in part, by Medicaid, Medicare (including Medicare Part D), Medicare Advantage Plans, Medigap, Veterans Affairs, Department of Defense or TRICARE, or other federal or state programs (including any state prescription drug assistance programs). 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. Additionally, Aspergillus infections have occurred in immunocompromised and neutropenic patients. ET Headquarters: The Assistance Fund 4700 Millenia Blvd., Suite 410 Make sure your child receives vaccinations against Streptococcus pneumoniae and Haemophilis influenzae type b (Hib) if treated with ULTOMIRIS. The enrollment form can be found at www.AlexionOneSource.com/CoPayForm. Copay cards for patients. This program is for patients with private or commercial insurance. Tell your doctor about any side effect that bothers you or that does not go away. Thank you for visiting our online portal. Prescribers must counsel patients about the risk of meningococcal infection, provide the patients with the REMS educational materials, and ensure patients are vaccinated with meningococcal vaccine(s). 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. No, By checking this box and submitting this form, I give, Available Resources For Your Patients And Your Practice, Help your patients understand their health insurance coverage for SOLIRIS, Explore alternative funding options and financial resources, Provide your patients with educational resources and supporting materials related to anti-AChR antibody-positive gMG, Connect patients with other adults living with anti-AChR antibody-positive gMG by informing them of in-person and online events, patient meetings, and advocacy groups, Ensure each patient can continue their plan of care while on vacation, traveling for business, moving, heading to college, or changing insurance. This site can help you enroll in the co-pay program and activate or replace your co-pay coupon card. Your risk of meningococcal infection may continue for several weeks after your last dose of SOLIRIS. Additional financial assistance. Fill out the form with patient information and fax to OneSource at 1-800-420-5150 or email to OneSource@alexion.com. There is no copay card available for Soliris, but the OneSource program from manufacturer Alexion can help patients navigate health insurance. Yes This program is for patients with private or commercial insurance. The cost for Soliris intravenous solution (10 mg/mL) is around $6,820 for a supply of 30 milliliters, depending on the pharmacy you visit. Prescription Hope is not an insurance policy or discount drug program. Patient Assistance Programs. OneSource™ team members act as a bridge between you, your staff, and your patients to help support and facilitate your treatment plan. * Get the Card Now. Siliq Solutions Instant Savings Program. Great but recommended not to be taken with food I have had stomach issues for the past 4 years. Under the Soliris REMS, prescribers must enroll in the program. Our program is also not a Soliris Generic. No home remedy or medication worked. If you do not have insurance or your insurance does not cover your medicine, you must meet different financial criteria. * ENROLL NOW. Patients’ site of care will be responsible for submitting the appropriate insurance paperwork for reimbursement. SOLIRIS is only available through a program called the SOLIRIS REMS. 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. You must receive meningococcal vaccines at least 2 weeks before your first dose of ULTOMIRIS if you are not vaccinated. Patient assistance programs (PAPs) are programs created by drug companies, such as ALEXION PHARMACEUTICALS, to offer free or low cost drugs to individuals who are unable to pay for their medication. Be prescribed SOLIRIS for an FDA-approved indication by a licensed US physician, Reside and receive treatment with SOLIRIS in the United States or its territories. ALEXION PHARMACEUTICALS Patient Assistance Program. ULTOMIRIS is not used in treating people with Shiga toxin E. coli related hemolytic uremic syndrome (STEC-HUS). Patient assistance programs (PAPs) are programs created by drug companies, such as ALEXION PHARMACEUTICALS, to offer free or low cost drugs to individuals who are unable to pay for their medication. No, IMPORTANT SAFETY INFORMATION INCLUDING BOXED WARNING. ULTOMIRIS may also increase the risk of other types of serious infections. TERMS AND CONDITIONS. SOLIRIS can lower the ability of your immune system to fight infections. Patients residing in Massachusetts, Minnesota, and Rhode Island are eligible for assistance with medication costs, but are not eligible for assistance with infusion costs. Symptoms of an infusion-related reaction with ULTOMIRIS may include lower back pain, pain with the infusion, feeling faint or discomfort in your arms or legs. 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. Alexion Complement Foundation. 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. TERMS AND CONDITIONS. Alexion®, ULTOMIRIS®, and Soliris® are registered trademarks and OneSource is a trademark of Alexion Pharmaceuticals, Inc. Soliris is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS). The Co-pay Card is not health insurance. Figuring out how to manage atypical-HUS can be difficult to navigate. Provides premium, co-pay and medical assistance to individuals diagnosed with Myasthenia Gravis (MG). The Co-pay Card will be accepted only at participating pharmacies. HCP for physicians. Description of Services . SOLIRIS is only available through a program called the SOLIRIS REMS. Please see full Prescribing Information for Soliris, including Boxed WARNING regarding serious meningococcal infections. Meningococcal vaccines reduce but do not prevent all meningococcal infections. Ask your doctor if you are not sure if you need to be revaccinated. Pfizer reserves the right to rescind, revoke, or amend the Co-pay Card without notice. NeedyMeds has free information on medication and healthcare costs savings programs including prescription assistance programs and medical and dental clinics. (See. Sign up to stay informed about SOLIRIS® (eculizumab). 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 . Everyone can qualify. Carry it with you at all times during treatment and for 8 months after your last ULTOMIRIS dose. Interrupt Soliris infusion and institute appropriate supportive measures if signs of cardiovascular instability or respiratory compromise occur. Prescription Hope is not a Soliris coupon card or insurance policy. 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. Receive CoPay ID number from OneSource Our program is also not a Soliris Generic. US/ULT-a/0178, Have commercial insurance that covers some portion of the drug and/or infusion cost, Have a valid ULTOMIRIS prescription for a US Food and Drug Administration-approved indication, Be a citizen or permanent resident of the United States or its territories. Ideal for drug isn't covered by your insurance and Your insurance has no drug coverage, And The card maybe offers a better price than your copay. You should not breastfeed during treatment and for 8 months after your final dose of ULTOMIRIS. 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. Patients should be instructed that if they develop fever, headache accompanied with fever and/or stiff neck or sensitivity to light, they should immediately seek medical care as these signs may be indicative of meningococcal infection. For help with the CAVERJECT IMPULSE $20 Co-Pay Card, call 1-866-300 … 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. It assists with co-pay and co-insurance costs for AUBAGIO prescriptions, regardless of your financial status. This is a copay assistance program for patients that have health insurance. Prescription Hope is not a Soliris coupon card or insurance policy. Comply with the most current Advisory Committee on Immunization Practices (ACIP) recommendations for meningococcal vaccination in patients with complement deficiencies. Soliris 300 mg/30 mL single-use vials for injection: 25682-0001-xx VII. This offer is good only in the United States and Puerto Rico. Ultomiris offers may be in the form of a printable coupon, rebate, savings card, trial offer, or free samples. Print Free Discount Card. Get more information to find out if it could be right for you. If you had a meningococcal vaccine in the past, you might need additional vaccination. CoPay Program. This includes the OCREVUS Co-pay Card and support from independent co-pay assistance foundations. Prices are for cash paying customers only and are not valid with insurance plans. Vaccination reduces, but does not eliminate, the risk of meningococcal infections. Treat atypical-HUS with up to 8 weeks of freedom a. The use of Soliris increases a patient’s susceptibility to serious meningococcal infections (septicemia and/or meningitis). No membership fees apply . ULTOMIRIS Patient Safety Card; STEP 02. Your doctor will give you a Patient Safety Card about the risk of meningococcal infection. SOLIRIS is only available through a program called the SOLIRIS REMS. Copyright © 2020 Alexion Pharmaceuticals, Inc. All rights reserved. Carry it with you at all times during treatment and for 3 months after your last SOLIRIS dose. Your doctor will give you a Patient Safety Card about the risk of meningococcal infection. Eligibility. Monitor patients for early signs of meningococcal infections and evaluate immediately if infection is suspected. Pfizer RxPathways ® may be able to help. Offer valid from 4/15/14 to 12/31/18. The HUMIRA Complete Savings Card may reduce your cost for HUMIRA to as little as $5 a month, every month. Soliris Prices. The free Drugs.com Discount Card works like a coupon and can save you up to 80% or more off the cost of prescription medicines, over-the-counter drugs and pet prescriptions. 2. Soliris is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS). Ideal for drug isn't covered by your insurance and Your insurance has no drug coverage, And The card maybe offers a better price than your copay. If your doctor decided that urgent treatment with ULTOMIRIS is needed, you should receive meningococcal vaccination as soon as possible. Pfizer reserves the right to rescind, revoke, or amend the Co-pay Card without notice. Under the Soliris REMS, prescribers must enroll in the program. See Important Safety Information, including Boxed Warning, and full Prescribing Information. This offer is good only in the United States and Puerto Rico. * ENROLL NOW. No membership fees apply * Subject to a $20,000 maximum benefit for 12 months from your first eligible date of program participation. The patient's insurance must cover the qualifying medication that they are seeking assistance for. For more information, ask your doctor or pharmacist. Prosecutors charge that the three companies made low-income Medicare patients ineligible for free drugs in order to steer them into copay assistance programs, thereby illegally increasing company revenues. 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. Carry it with you at all times during treatment and for 8 months after your last ULTOMIRIS dose. Providers collect the applicable program’s copay as set forth by the Department. Alexion OneSource™ provides gMG patient support. What are the possible side effects of ULTOMIRIS? This website is intended for residents of the United States. SOLIRIS increases your chance of getting serious and life-threatening meningococcal infections. 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 … Enrolling in this program may help you save on your out-of-pocket medication costs for SILIQ (brodalumab) injection, for subcutaneous use. 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. Discontinue Soliris in patients who are undergoing treatment for serious meningococcal infections. Offer valid from 4/15/14 to 12/31/18. No claim for reimbursement of any out-of-pocket expense amount covered by the Program may be submitted to any third-party payer, whether public or private. Life-threatening and fatal meningococcal infections have occurred in patients treated with Soliris and may become rapidly life-threatening or fatal if not recognized and treated early. This Soliris Discount is similar to Buying Group Coupon. ULTOMIRIS is a prescription medicine used to treat adults and children 1 month of age and older with a disease called atypical Hemolytic Uremic Syndrome (aHUS). It is not known if ULTOMIRIS is safe and effective in children younger than 1 month of age. Immunize patients without a history of meningococcal vaccination at least 2 weeks prior to receiving the first dose of Soliris. 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. Enroll in the ULTOMIRIS REMS Click here to complete the ULTOMIRIS REMS Prescriber Enrollment online Or Print and sign the Prescriber Enrollment Form. Enrolling in this program may help you save on your out-of-pocket medication costs for SILIQ (brodalumab) injection, for subcutaneous use. 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. You may report side effects to FDA at 1-800-FDA-1088. The SYNAGIS Copay Program helps lower out-of-pocket costs for eligible patients receiving SYNAGIS. By using our website, you agree to our use of cookies in accordance with our cookie policy. Drugs.com Printable Discount Card. Call your doctor or get emergency medical care right away if you get any of these signs and symptoms of a meningococcal infection: headache with nausea or vomiting, headache and fever, headache with a stiff neck or stiff back, fever, fever and a rash, confusion, muscle aches with flu-like symptoms and eyes sensitive to light. 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. The most common side effects of ULTOMIRIS in people with aHUS are upper respiratory infection, diarrhea, nausea, vomiting, headache, high blood pressure and fever. Guidelines for the diagnosis and monitoring of paroxysmal nocturnal hemoglobinuria and related disorders by flow cytometry. Phone: (855) 845-3663 Patient Fax: (833) 865-3757 Business Fax: (855) 430-0590 Monday - Friday, 9 a.m. - 6 p.m. Allegedly, the “referral portal” reported information back to Alexion confirming those Soliris patients who were approved for copay or other financial assistance from the foundation, and detailed the foundation’s payments to them, which resulted in claims to Medicare to cover the cost of Soliris. Have a question? Siliq Solutions Instant Savings Program. 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. Contraindications. Phone: 1-877-757-0667 Fax: 1-888-899-0067 www.usbioservices.com 2 3 Physician office/clinic or hospital pharmacies LENVIMA is also available to eligible in-office and hospital-based Call your doctor right away if you have any new signs or symptoms of infection. Only need to present this card to participating pharmacy to get discount on Soliris prescription. NeedyMeds has free information on medication and healthcare costs savings programs including prescription assistance programs and medical and dental clinics. You will receive communication from OneSource containing the CoPay ID number. The HUMIRA Complete Savings Card may reduce your cost for HUMIRA to as little as $5 a month, every month. This Soliris price guide is based on using the Drugs.com discount card which is accepted at most U.S. pharmacies. Most programs have income, age, and other eligibility requirements. Soliris is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS). Everyone can qualify. Patients who are not currently vaccinated against. Fill out the Alexion OneSource CoPay Program enrollment form Please see accompanying full Prescribing Information and Medication Guide for ULTOMIRIS, including Boxed WARNING regarding serious and life-threatening meningococcal infections/sepsis. The Alexion OneSource CoPay Program helps patients pay for eligible out-of-pocket medication and infusion costs. We use cookies to give you the best online experience. Please note: This is a … As with PACE, PA PAP pays providers via EFT and distributes a separate PA Patient Assistance Program Remittance Advice. If you would like to speak to someone directly, please call 1-877-505-6986 1-877-505-6986. – – – Co-contributors: Jeroen van Meijgaard, PhD, Jennifer Tran, PharmD, and Tori Marsh, MPH. Patients may have increased susceptibility to infections, especially with encapsulated bacteria. Symptoms or problems that can happen with TMA may include: confusion or loss of consciousness, seizures, chest pain (angina), difficulty breathing and blood clots or stroke. Yes … The SYNAGIS Copay Program helps lower out-of-pocket costs for eligible patients receiving SYNAGIS. Your doctor will give you a Patient Safety Card about the risk of meningococcal infection. 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! Steve Contact OneSource at 1-888-765-4747. NeedyMeds is the best source of information on organizations offering programs that help with costs associated with specific diagnoses. Enrolled cardholders received a unique ID card verifying their enrollment in any of the PA Patient Assistance Programs. Direct any questions to OneSource. ULTOMIRIS can cause serious side effects including infusion-related reactions. OTC drugs such as Zantac, Nexium, and Protonix provided no benefit. Serious infections with Neisseria species (other than N. meningitidis), including disseminated gonococcal infections, have been reported. This Soliris Discount is similar to Buying Group Coupon. Tell your doctor about all the vaccines you receive and medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements which could affect your treatment. Eligible patients may pay as little as $0 in out-of-pocket costs relating to medication and infusions. Your risk of meningococcal infection may continue for several weeks after your last dose of SOLIRIS. Not used in treating people with STEC-HUS. Prescription Hope is a national advocacy program that works with any coverage you may already have. Patient with Medicare Part D will be considered on a case by case basis. Received an invoice? This offer cannot be combined with any other rebate/coupon, free trial, or similar offer. SOLIRIS is a medicine that affects your immune system. When enrolling you will have to answer a few questions to confirm you are eligible for the program. Copay assistance snares 3 drug companies in Medicare kickback charges Getty Images Author By. 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. Patient assistance has been a sore point with both government and private insurance plans because they can drive patients to higher-priced drugs … Under the Soliris REMS, prescribers must enroll in the program [see Warnings and Precautions (5.2)]. OneSource is a complimentary, personalized patient support program offered by Alexion and tailored to the specific needs of people living with aHUS, gMG, HPP, LAL-D, NMOSD and PNH. Vaccinate or revaccinate for meningococcal disease according to the most current ACIP recommendations for patients with complement deficiencies. It is important to show this card to any doctor or nurse who treats you. ULTOMIRIS is only available through a program called the ULTOMIRIS REMS. One day I after suffering from extreme stomach pain and vomiting went to the emergency room. The Alexion OneSource CoPay Program helps patients pay for eligible out-of-pocket medication and infusion costs. Half-life of eculizumab is 11.25-17.25 days. It is important to show this card to any doctor or nurse who treats you. Boston, MA; Alexion Pharmaceuticals, Inc; June 2019. The Alexion OneSource™ CoPay Program (“Program”) pays for eligible out-of-pocket medication and infusion costs associated with SOLIRIS up to $15,000 US dollars per calendar year. For treatment of atypical-HUS in adults and children 1 month of age and older. Now I will be comparing prices!" Under the Soliris REMS, prescribers must enroll in the program. Copyright © 2021, Alexion Pharmaceuticals, Inc. All rights reserved. As part of the Alexion OneSource suite of services, a financial support program is now available for eligible patients. Soliris is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS).
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