Ultomiris

Indicated For

PNH, aHUS, gMG

About This Medication

# Alexion OneSource CoPay Program Patient Guide: How to Get Ultomiris (ravulizumab-cwvz) at Low or No Cost Ultomiris (ravulizumab-cwvz) is a prescription medication used to treat certain rare conditions like paroxysmal nocturnal hemoglobinuria (PNH), atypical hemolytic uremic syndrome (aHUS), generalized myasthenia gravis (gMG), and neuromyelitis optica spectrum disorder (NMOSD). The **Alexion OneSource CoPay Program**, offered by manufacturer **Alexion Pharmaceuticals**, helps eligible commercially insured patients reduce out-of-pocket costs for Ultomiris medication and infusion to as low as **$0**.[1][2][6] ## About Ultomiris and Why Assistance Matters Ultomiris is a monoclonal antibody that targets the complement system to prevent damage from rare diseases. It's administered via intravenous infusion every 8 weeks after loading doses, making it a long-term, high-cost therapy. Without help, costs can be substantial, but the OneSource program provides financial relief by covering copays, coinsurance, and deductibles for eligible patients.[2][7] Importantly, Ultomiris is only available through the **ULTOMIRIS and SOLIRIS REMS program** due to risks of serious meningococcal infections. Your doctor must enroll in REMS, counsel you on risks, ensure you're vaccinated against meningococcal bacteria (or start antibiotics if needed), and give you a Patient Safety Card.[1][3][4] ## Who Qualifies for the Program? Eligibility focuses on insurance type and residency, **not income**—there's no FPL or household size threshold.[2][6] You may qualify if you: - Are enrolled in Alexion OneSource patient support. - Have **commercial private insurance** covering part of Ultomiris drug or infusion costs. - Have a valid prescription for an FDA-approved indication. - Are a U.S. citizen or permanent resident (including territories). - **Do not have government insurance** like Medicare (including Part D or Advantage), Medicaid, Medigap, VA, TRICARE, or state programs.[2][6] **Note:** Residents of Massachusetts or Rhode Island can get medication cost help but not infusion assistance.[2] The program is **not health insurance** and can't be combined with government programs.[1] ## Income Eligibility Breakdown This program has **no income limits**. It's designed for commercially insured patients regardless of earnings. Here's a simple table: | Household Type | Income Threshold | Eligible? | |---------------|------------------|-----------| | Individual | None | Yes, if commercially insured[2] | | Couple | None | Yes, if commercially insured[2] | | Family of 3 | None | Yes, if commercially insured[2] | | Family of 4 | None | Yes, if commercially insured[2] | Always verify with OneSource, as terms can change.[1] ## Insurance Requirements **Commercial insurance is required**—government plans disqualify you.[2][6] Your plan must cover some Ultomiris costs. OneSource helps navigate prior authorizations, appeals, and benefits investigations. If uninsured or underinsured, ask about other Alexion options, though copay help is commercial-only.[1][10] ## Step-by-Step Application Process 1. **Discuss with Your Doctor:** Ensure REMS enrollment, vaccination, and a valid Ultomiris prescription. Download the Patient & Prescriber Start Form from Alexion sites.[5][10] 2. **Enroll in OneSource:** Complete the start form online, or download and submit via email (OneSource@Alexion.com) or fax (1-800-420-5150). Include consent for health info sharing.[10] 3. **Call OneSource:** Contact 1-888-765-4747 (Mon-Fri, 8AM-8PM ET) for personalized help, insurance navigation, or form assistance.[9] 4. **Submit Prescription:** Your doctor sends the prescription; OneSource verifies eligibility and activates copay card.[1][5] 5. **Get Copay Card:** Use at pharmacy or infusion center for instant savings up to program limits (terms apply).[2] OneSource offers nurse case managers, education, and community support too.[9] ## Timeline and Delivery Processing is typically quick—enrollment and copay activation can happen same-day via phone, but allow 1-2 weeks for full setup including insurance verification. Medication ships to authorized infusion centers only (not home delivery due to REMS).[1][3] Infusions occur outpatient; OneSource covers eligible costs. Refills auto-process if eligible; reauthorization may be needed annually or per insurance.[7] ## Alternatives if Denied or Ineligible - **Government Insurance:** Explore Medicare Extra Help, state programs, or patient access networks like PAN Foundation (not Alexion-affiliated). - **Uninsured/Low Income:** Contact NeedyMeds or RxAssist for free drug programs; Alexion may have bridge options via OneSource.[1] - **Appeals:** OneSource assists with insurance appeals.[3] - **Biosimilars:** None currently available.[ ] - **Patient Assistance Foundations:** Check HealthWell or Patient Access Network for rare disease funds. ## Important Disclaimer This guide is for informational purposes only and not medical or financial advice. Eligibility, benefits, and terms can change; always confirm with Alexion OneSource at 1-888-765-4747 or alexiononesource.com. Program not guaranteed; subject to fund availability. Consult your doctor for treatment decisions. Data current as of available sources; visit UltSolREMS.com for REMS details.[1][2][10] (Word count: 912)

Program information last verified: March 30, 2026