Thank you for downloading this patient assistance document from NeedyMeds. We hope this program will help you get the medicine you need. Did you know that NeedyMeds has thousands of other free resources? Here s a look at more ways we can help you save money on medicine and healthcare costs. Each one can be found under the Patient Savings tab on our website: Diagnosis-Based Assistance NeedyMeds lists thousands of assistance programs for almost any health condition. If you are going through chemo treatment for cancer, there are programs that can help with wig costs and scalp-cooling products. We also list resources for free diabetes testing supplies, caregiver lodging support, and much more. Free, Low Cost, and Sliding Scale Clinics This popular collection contains information on 16,000+ free, low cost, and sliding scale medical and dental clinics across the U.S. It s a great resource if you need affordable medical treatment and don t know where to go. Coupons, Rebates & More You can use the NeedyMeds website to find nearly 2,000 cost-saving opportunities for both prescription and over-the-counter drugs and medical supplies. Medical Transportation Need help getting to the doctor s office or medical facility? You may be eligible for financial assistance if you meet certain requirements. NeedyMeds also offers information on diagnosis-based camps and retreats, recreational programs, scholarships, government programs, $4 generic drug programs, and more. Finally, I want to tell you about the NeedyMeds Drug Discount Card. Thousands of people use this free, anonymous, and easy-to-use tool to get the best price on their medications. To date, our drug discount card has saved patients over $244,000,000. Check out the next page to learn more. Feel free to call our toll-free helpline if you have any questions. You can reach us at 1-800-503-6897 Monday-Friday, 9am-5pm Eastern Time. Thanks for using NeedyMeds! Please let us know if we can do anything else to help you afford the costs of your healthcare. Rich Sagall, MD President, NeedyMeds
Clip the card and save NeedyMeds NeedyMeds.org DRUG DISCOUNT CARD BIN: 019520 RX PCN: NMEDS RX GRP: PDFPDF ID: NMNA019309901930 This is a drug discount program, not an insurance plan. NeedyMeds Drug Discount Card www.needymeds.org Patient: Simply present this card to a participating pharmacy to receive a discount on your prescription. Patients who have Medicare, including Part D, Medicaid or any state or federal prescription insurance can only use this card if they choose not to use their government-sponsored drug plan for their purchase. The card is not valid in combination with those programs. For questions concerning the card, call 1-888-602-2978 or visit www.drugdiscountcardinfo.com. Pharmacist: Card must be presented to receive program benefits. Clear system of prior cardholder information associated with this universal cardholder ID. For processing questions, call Argus Health Systems at 1-866-921-7286. Save up to 80% Use at over 65,000 pharmacies nationwide including all major chains Share the card with friends and family Use the card as often as needed Free, no fees or registration Never expires What if I have insurance? Anyone can use the card, but it can t be combined with insurance. You can use the card instead of insurance if: A drug isn t covered by your insurance Your insurance has no drug coverage You have a high drug deductible You have met a low medicine cap The card offers a better price than your copay You are in the Medicare Part D donut hole What drugs are covered? The card is good for prescription drugs, over-the-counter medicines and medical supplies if written on a prescription blank, and pet prescription medicines purchased at a pharmacy. You ll save on most, but not all, prescriptions. To obtain a plastic drug discount card, send a self-addressed stamped envelope to: NeedyMeds-PAP PO Box 219 Gloucester, MA 01931 The card is not valid in combination with other insurance plans, including Medicare, Medicaid or any state or federal prescription insurance. The card can be used only if you decide not to use your government-sponsored drug plan for your purchases.
T R E A T M E N T S U P P O R T If you have PNH or ahus, we re here for you
T R E A T M E N T S U P P O R T Having a rare disease can be overwhelming. It s nice to have someone there every step of the way to help answer questions and provide support. Soliris patient
To learn more, just call 1.888.SOLIRIS (1.888.765.4747) to speak directly with an Alexion Nurse Case Manager. Soliris is a prescription medicine called a monoclonal antibody. Soliris is used to treat people with: a disease called Paroxysmal Nocturnal Hemoglobinuria (PNH). PNH affects red blood cells a disease called atypical Hemolytic Uremic Syndrome (ahus). ahus affects the blood system, kidney, and sometimes other body organs Soliris works by blocking part of your immune system. This can help your symptoms but it can also increase your chance for infection. OneSource can help We offer personalized support every step of the way. Whether you just want to learn more about PNH or ahus, are considering Soliris, or are already on treatment, OneSource is here to help. Alexion s objective is that every patient with PNH or ahus, who can benefit from Soliris, will have access to Soliris. OneSource is a program offered by Alexion, staffed by Alexion Nurse Case Managers. We provide one-to-one education, assistance with funding options and access to Soliris, as well as ongoing treatment support for people living with PNH or ahus, and their caregivers. T R E A T M E N T S U P P O R T Please see enclosed full prescribing information for Soliris, including boxed WARNING regarding serious meningococcal infection.
Dealing with a rare disease can be an isolating experience. Patients often feel like they re alone, but that s why I m here. I can hear the relief in their voices when I help with something that s been troubling them. That s a good feeling for them and me. Alexion Nurse Case Manager OneSource: The support you need designed just for you People just like you have told us: Living with a rare disease like PNH or ahus can be tough. That s why Alexion created OneSource. OneSource is staffed by Alexion Nurse Case Managers, who are registered nurses with healthcare and insurance experience. An Alexion Nurse Case Manager can provide support designed just for you and your healthcare team every step of the way, whether you are learning more about your disease, exploring treatment options, getting ready to begin Soliris therapy, or currently being treated with Soliris. When my insurance provider denied my Soliris coverage, my heart sank. My Alexion Nurse Case Manager answered all of my questions about insurance coverage and helped guide me through the system. We explored every avenue and, thanks to her help, my Soliris is covered. Now I am feeling better and doing the things I enjoy most. Soliris patient Just remember, your doctor is the one who decides whether Soliris therapy is right for you.
Whether you have a general question or are seeking help with funding options or arranging your Soliris therapy, OneSource is here to help. Just call 1.888.SOLIRIS (1.888.765.4747). Remember, information provided by OneSource is meant to add to what you have learned from your doctor. Only you and your doctor can decide how best to monitor and manage your disease. At Alexion, we respect patient confidentiality When you call OneSource with a general question about PNH, ahus, or Soliris, we don t need special permission to share information with you. More often, however, people contact OneSource when they have specific questions regarding their own situation. When the conversation involves your medical condition or financial options, we ll need your written permission to work with others to gather and share answers with you. The process for giving your permission is simple. OneSource will provide an Authorization Form, which you will need to return to your Alexion Nurse Case Manager after signing it in 2 places. This allows us to work with your insurance company or other financial sources to explore your funding options. In fact, OneSource takes your privacy seriously. Even with your permission, we only share personal information with others on an as needed basis. T R E A T M E N T S U P P O R T Please see enclosed full prescribing information for Soliris, including boxed WARNING regarding serious meningococcal infection.
What can an Alexion Nurse Case Manager do for you? Just call 1.888.SOLIRIS (1.888.765.4747), toll free, and with no obligation, to find: Education Alexion Nurse Case Managers work with people with PNH and ahus every day. Feel free to ask them about PNH, ahus, or Soliris. They can help provide answers and send you useful educational resources. Assistance with access to Soliris OneSource can help you and your doctor find your way through insurance coverage issues, funding options, and other needs that are important to your treatment plan. Ongoing treatment support If you and your doctor decide that Soliris is right for you, your Alexion Nurse Case Manager can help answer questions and let you know what to expect throughout your Soliris therapy. Whether you are traveling, changing your insurance, or experiencing a major life event, be it a marriage, a job change, or even a change of address, we re here for you every step of the way. Shared connections If you want to speak with someone who knows what you re going through, your Alexion Nurse Case Manager can put you in touch with another person also living with your disease. I was really nervous before my first infusion because I didn t know what it would be like. My Nurse Case Manager walked me through exactly what would happen and what to expect on that day. She helped answer my questions, which made me feel more prepared. Thanks to her, I felt at ease at my first infusion and they have been going well ever since. Soliris patient Serious allergic reactions can happen during your Soliris infusion. Tell your doctor or nurse right away if you get any of these symptoms during your infusion: chest pain; trouble breathing or shortness of breath; swelling of your face, tongue, or throat; or feeling faint or passing out.
You are not alone Although PNH and ahus are rare, support is not hard to come by. Call OneSource at 1.888.SOLIRIS (1.888.765.4747) to speak one-to-one with an Alexion Nurse Case Manager. Case managers can assist you with additional education and helpful resources, information about insurance issues, funding options, and ongoing treatment support as you and your doctor manage your condition. They can even put you in touch with other people living with your disease. T R E A T M E N T S U P P O R T Please see enclosed full prescribing information for Soliris, including boxed WARNING regarding serious meningococcal infection.
T R E A T M E N T S U P P O R T Available to people with PNH, ahus, and their caregivers When we decided to attend our grandson s graduation, my Nurse Case Manager arranged for me to receive Soliris at an infusion center halfway across the country. Not only did that make it possible for me to travel, but I also was able to relax and enjoy myself, knowing that I was not going to miss a scheduled infusion. More importantly, I was able to be part of a family celebration, something I will appreciate and remember forever. Soliris patient Call with no obligation: 1.888.SOLIRIS (1.888.765.4747)
Support is just a phone call away 1.888.SOLIRIS (1.888.765.4747) OneSource is a free program that provides education, access to Soliris therapy, and ongoing treatment support for people living with PNH and ahus Alexion Nurse Case Managers are registered nurses with healthcare and insurance experience, who are here to help answer your questions and offer support designed just for your needs Important Safety Information WARNING: SERIOUS MENINGOCOCCAL INFECTIONS See full prescribing information for complete boxed warning 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. Comply with the most current Advisory Committee on Immunization Practices (ACIP) recommendations for meningococcal vaccination in patients with complement deficiencies. Immunize patients with a meningococcal vaccine at least 2 weeks prior to administering the first dose of Soliris, unless the risks of delaying Soliris therapy outweigh the risks of developing a meningococcal infection. (See Serious Meningococcal Infections for additional guidance on the management of the risk of meningococcal infection.) Monitor patients for early signs of meningococcal infections, and evaluate immediately if infection is suspected. 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. Soliris is a registered trademark of Alexion Pharmaceuticals, Inc. 2014, Alexion Pharmaceuticals, Inc. All rights reserved. 0614.9.4.1.017