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Alexion Complement Foundation
SOURCE: 2008 Poverty Chart
| Family Size | 100% | 133% | 150% | 200% | 250% | 300% |
| 1 | $10,830 | $14,404 | $16,245 | $21,660 | $27,075 | $32,490 |
| 2 | $14,570 | $19,378 | $21,855 | $29,140 | $36,425 | $43,710 |
| 3 | $18,310 | $24,352 | $27,465 | $36,620 | $45,775 | $54,930 |
| 4 | $22,050 | $29,327 | $33,075 | $44,100 | $55,125 | $66,150 |
| 5 | $25,790 | $34,301 | $38,685 | $51,580 | $64,475 | $77,370 |
| 6 | $29,530 | $39,275 | $44,295 | $59,060 | $73,825 | $88,590 |
| 7 | $33,270 | $44,249 | $49,905 | $66,540 | $83,175 | $99,810 |
| 8 | $37,010 | $49,223 | $55,515 | $74,020 | $92,525 | $111,030 |
| For each additional family member | $3,740 | $4,974 | $5,610 | $7,480 | $9,350 | $11,220 |
What´s Next?
Fill out the program enrollment form located to your right. If you don’t see an enrollment form available please call Alexion Pharmaceuticals program directly. After filling out the enrollment form please bring the form to your doctor for proper signatures and procedures. Do not forget a self stamped envelope for them to mail in your application to the program.
Other Tips
- If you have any questions please call the Alexion Pharmaceuticals program directly
- Fill out as much of the information on the enrollment form as possible. The more information you have pre-filled the easier the progrm is to enroll in
- Write down the refill dates for your program and set a reminder here on PatientAssistance.com so that you don’t run out of medication.
- Do not write messy on your forms as this will delay any response
- Call and write thank you notes to Alexion Pharmaceuticals program. Without their help millions of people will be without medication.
- PAP Links:
- Website:
- Address:
- Phone:
- Fax:
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List of Medications
Soliris 300 Mg Vial (eculizumab)
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