Alexion OneSource Patient Assistance Program (Ultomiris)

Manufacturer copay assistance · Ultomiris (J1303) · Alexion (AstraZeneca Rare Disease)

$0 — free drug for… · Maximum benefit Free Ultomiris for qualifying patients without coverage or with financial concerns · Free Ultomiris drug shipped to provider — does not cover infusion administration

OPEN
Status verified April 8, 2026 · Source: program site ↗

Program terms

Published terms from the manufacturer. Per-patient eligibility is confirmed at enrollment.

Assistance type
Free Drug
Patient pays
$0 — free drug for qualifying uninsured/underinsured patients
Maximum benefit
Free Ultomiris for qualifying patients without coverage or with financial concerns
What it covers
Free Ultomiris drug shipped to provider — does not cover infusion administration
Insurance
uninsured
Income limit
Income limits apply (typically up to ~500% FPL for rare disease PAPs)

What will the patient owe before assistance?

Run a benefits estimate for Ultomiris — the program's cap applies against the patient share CareCost calculates.

Common questions

Does Ultomiris have a copay card?

Yes — Alexion OneSource Patient Assistance Program (Ultomiris) from Alexion (AstraZeneca Rare Disease). $0 — free drug for qualifying uninsured/underinsured patients. Commercial insurance is typically required.

How much does Ultomiris cost with the copay card?

$0 — free drug for qualifying uninsured/underinsured patients Maximum benefit: Free Ultomiris for qualifying patients without coverage or with financial concerns. Free Ultomiris drug shipped to provider — does not cover infusion administration

Who is eligible for Alexion OneSource Patient Assistance Program (Ultomiris)?

Accepted insurance: uninsured. Income limit: Income limits apply (typically up to ~500% FPL for rare disease PAPs).

Patient or caregiver? Your infusion center's financial counselor can enroll you — or call the program at 888-765-4747.