Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
 

OneSource Treatment Support (Kanuma)

This program provides brand name medications at no or low cost

Provided by: Alexion Pharmaceuticals, Inc.


TEL: 888-765-4747


Languages Spoken:

English

Program Website

 

Patient Assistance Applications

OneSource Enrollment and Authorization Form (Kanuma)

OneSource Enrollment (Patient Consent) Form (Kanuma)

OneSource Treatment Support Statement of Medical Necessity (Kanuma)

OneSource Treatment Support Brochure (Kanuma)

 

Brand Name Medications Covered

 
  • Kanuma
 

Generic Name

 
  • sebelipase alfa
 

Eligibility Requirements   

Insurance Status Determined case by case
Those with Part D Eligible? No
Income Determined case by case
Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
US Residency Required? Not specified
   

Application

Obtaining Call or download
Receiving Downloaded from website
Returning Fax
Doctor's Action Complete section and sign
Applicant's Action Complete section and sign
Decision Communicated Not specified
Decision Timeframe Not specified
   

Medication

Amount/Supply Not specified
Sent To Not specified
Delivery Time Not specified
Refill Process Not specified
Limit Not specified
Re-application Not specified
   

Additional Information

Insurance benefits, claims assistance, or other reimbursement help is offered.

This program also provides copay assistance.


Updated October 11, 2017