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Ultomiris Prices, Coupons and Patient Assistance Programs

Ultomiris (ravulizumab) is a member of the selective immunosuppressants drug class and is commonly used for Hemolytic Uremic Syndrome, Myasthenia Gravis, and Paroxysmal Nocturnal Hemoglobinuria.

Ultomiris prices

The cost for Ultomiris intravenous solution (100 mg/mL) is around $6,753 for a supply of 3 milliliters, depending on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans.

This Ultomiris price guide is based on using the discount card which is accepted at most U.S. pharmacies.

Intravenous Solution Printable Discount Card

The free Discount Card works like a coupon and can save you up to 80% or more off the cost of prescription medicines, over-the-counter drugs and pet prescriptions.

Print Free Discount Card

Please note: This is a drug discount program, not an insurance plan. Valid at all major chains including Walgreens, CVS Pharmacy, Target, WalMart Pharmacy, Duane Reade and 65,000 pharmacies nationwide.

Ultomiris Coupons and Rebates

Ultomiris offers may be in the form of a printable coupon, rebate, savings card, trial offer, or free samples. Some offers may be printed right from a website, others require registration, completing a questionnaire, or obtaining a sample from the doctor's office.

Ultomiris Alexion OneSource CoPay Program: Eligible commercially insured patients may pay as little as $0 in out-of-pocket costs up to a maximum savings of $15,000 per calendar year; for additional information contact the program at 888-765-4747.

Applies to:
Number of uses:
per prescription per calendar year

Form more information phone: 888-765-4747 or Visit website

Patient Assistance Programs for Ultomiris

Patient assistance programs (PAPs) are usually sponsored by pharmaceutical companies and provide free or discounted medicines to low income or uninsured and under-insured people who meet specific guidelines. Eligibility requirements vary for each program.

Provider: Patient Access Network Foundation (PAN)

Elligibility requirements:
  1. *See Additional Information section below
  2. Between 400-500% of FPL
  3. FDA Approved Diagnosis - See Program Website for Details
  4. Must reside and receive treatment in US
  5. *Patients must have health insurance and their insurance must cover the qualifying medication for which they seek assistance. Call for most recent medications as the list is subject to change and the medication for which you are seeking assistance must treat the disease directly. Note: All new enrollment is now done electronically or over the phone. Contact program for details.
Applicable drugs:
  • Ultomiris (ravulizumab-cwvz) Injection; IV

More information please phone: 866-316-7263 Visit Website

Provider: OneSource Patient Support Program from Alexion

Elligibility requirements:
  1. Determined case by case
  2. Determined case by case
  3. FDA-approved diagnosis
  4. Must be treated by US licensed healthcare provider
  5. 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.
Applicable drugs:
  • Ultomiris (ravulizumab-cwvz) Injection; IV

More information please phone: 888-765-4747 Visit Website