Soliris eculizumab

The single biggest commercial risk for Soliris is not efficacy doubt but infusion-schedule fatigue driving voluntary switches to Ultomiris, a trend that peer mentorship at the 4-year vein-damage inflection point could meaningfully slow or redirect.

• Soliris earns intense gratitude as a literal lifesaver across PNH, aHUS, and gMG, but the every-two-week IV schedule is the dominant driver of voluntary switching to Ultomiris among patients who are otherwise stable and satisfied.
• Vein damage, scheduling constraints, and travel restrictions are the three patient-articulated reasons for leaving Soliris, not side-effect severity or lack of efficacy, meaning retention interventions must target logistics not pharmacology.
• Meningococcal infection risk is broadly understood by patients in this corpus but remains a source of ongoing low-level anxiety, particularly around the Patient Safety Card requirement and the nuance that vaccination does not fully eliminate risk.
• Biosimilar entry (Epysqli, Bkemv) is now a live conversation in patient communities, creating insurance-driven switching pressure that mirrors what Soliris itself created when it displaced plasma exchange as the standard of care.