| Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis. | |||
OneSource Patient Support Program from AlexionThis program provides brand name medications at no or low cost |
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Provided by: Alexion Pharmaceuticals, Inc. |
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TEL: 888-765-4747 |
Languages Spoken:
English, Spanish, Others By Translation Service |
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Program Applications and Forms |
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OneSource Enrollment and Authorization Form: Contact program |
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Medications |
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Eligibility Requirements |
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| Insurance Status | Determined case by case | ||
| Those with Part D Eligible? | No | ||
| Income | Determined case by case | ||
| Diagnosis/Medical Criteria | FDA-approved diagnosis | ||
| US Residency Required? | Must be treated by US licensed healthcare provider | ||
Application |
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| Obtaining | Call or complete online | ||
| Receiving | Varies | ||
| Returning | Varies | ||
| Doctor's Action | Varies | ||
| Applicant's Action | Call or enroll online | ||
| Decision Communicated | Not specified | ||
| Decision Timeframe | Not specified | ||
Medication |
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| Amount/Supply | Not specified | ||
| Sent To | Not specified | ||
| Delivery Time | Not specified | ||
| Refill Process | Not specified | ||
| Limit | Contact the program for details | ||
| Re-application | Contact program for details. | ||
Additional Information |
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| Insurance benefits, claims assistance, or other reimbursement help is offered. Health care providers must enroll in the REMS program prior to submitting the Patient Assistance Program Application Co-payment assistance, and patient assistance programs are available for eligible patients. |
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| Updated April 14, 2023 | |||
