UNITED STATES
                       SECURITIES AND EXCHANGE COMMISSION
                             Washington, D.C. 20549


                                  SCHEDULE 13G

                    Under the Securities Exchange Act of 1934




                          ALEXION PHARMACEUTICALS, INC.
                                (Name of Issuer)

                                  Common Stock
                         (Title of Class of Securities)

                                   0015351109
                                 (CUSIP Number)

                                January 29, 1999
             (Date of Event which Requires Filing of this Statement)


          Check the appropriate box to designate the rule pursuant to whichthis
Schedule is filed:

                   |_| Rule 13d-1 (b)
                   |x| Rule 13d-1 (c)
                   |_| Rule 13d-1 (d)




          * The remainder of this cover page shall be filled out for a reporting
          person's initial filing on this form with respect to the subject class
          of securities, and for any subsequent amendment containing information
          which would alter disclosures provided in a prior cover page.

          The information required on the remainder of this cover page shall not
          be deemed to be "filed" for the purpose of Section 18 of the
          Securities Exchange Act of 1934 ("Act") or otherwise subject to the
          liabilities of that section of the Act but shall be subject to all
          other provisions of the Act (however, see the Notes).


CUSIP No. 0015351109 (1) Name of Reporting Person S.S. or I.R.S. Identification No. of Above Person OrbiMed Advisers Inc. ---------------------------------------------------------------------- (2) Check the Appropriate Box if a Member of Group (See Instructions) [ ] (a) [ ] (b) ---------------------------------------------------------------------- (3) SEC Use Only ---------------------------------------------------------------------- (4) Citizenship or Place of Organization British Virgin Islands ---------------------------------------------------------------------- Number of (5) Sole Voting Power 0 Shares Beneficially ------------------------------------------------------------- Owned by (6) Shared Voting Power 750,500 Each - Reporting ------------------------------------------------------------- Person (7) Sole Dispositive Power 0 With ------------------------------------------------------------- (8) Shared Dispositive Power 750,500 ---------------------------------------------------------------------- (9) Aggregate Amount Beneficially Owned by Each Reporting Person 750,500 ---------------------------------------------------------------------- (10) Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) ---------------------------------------------------------------------- (11) Percent of Class Represented by Amount in Row (9) 6.7% ---------------------------------------------------------------------- (12) Type of Reporting Person (See Instructions) IA --------------------------

CUSIP No. 0015351109 (1) Name of Reporting Person S.S. or I.R.S. Identification No. of Above Person Worldwide Health Sciences Portfolio ---------------------------------------------------------------------- (2) Check the Appropriate Box if a Member of Group (See Instructions) [ ] (a) [ ] (b) ---------------------------------------------------------------------- (3) SEC Use Only ---------------------------------------------------------------------- (4) Citizenship or Place of Organization New York ---------------------------------------------------------------------- Number of (5) Sole Voting Power 0 Shares Beneficially ------------------------------------------------------------- Owned by (6) Shared Voting Power 750,500 Each - Reporting ------------------------------------------------------------- Person (7) Sole Dispositive Power 0 With ------------------------------------------------------------- (8) Shared Dispositive Power 750,500 ---------------------------------------------------------------------- (9) Aggregate Amount Beneficially Owned by Each Reporting Person 750,500 ---------------------------------------------------------------------- (10) Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) ---------------------------------------------------------------------- (11) Percent of Class Represented by Amount in Row (9) 6.7% ---------------------------------------------------------------------- (12) Type of Reporting Person (See Instructions) IV --------------------------

CUSIP No. 0015351109 (1) Name of Reporting Person S.S. or I.R.S. Identification No. of Above Person OrbiMed Advisors LLC ---------------------------------------------------------------------- (2) Check the Appropriate Box if a Member of Group (See Instructions) [ ] (a) [ ] (b) ---------------------------------------------------------------------- (3) SEC Use Only ---------------------------------------------------------------------- (4) Citizenship or Place of Organization Delaware ---------------------------------------------------------------------- Number of (5) Sole Voting Power 0 Shares Beneficially ------------------------------------------------------------- Owned by (6) Shared Voting Power 750,500 Each - Reporting ------------------------------------------------------------- Person (7) Sole Dispositive Power 0 With ------------------------------------------------------------- (8) Shared Dispositive Power 750,500 ---------------------------------------------------------------------- (9) Aggregate Amount Beneficially Owned by Each Reporting Person 750,500 ---------------------------------------------------------------------- (10) Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) ---------------------------------------------------------------------- (11) Percent of Class Represented by Amount in Row (9) 6.7% ---------------------------------------------------------------------- (12) Type of Reporting Person (See Instructions) CO --------------------------

CUSIP No. 0015351109 (1) Name of Reporting Person S.S. or I.R.S. Identification No. of Above Person Caduceus Capital Trust ---------------------------------------------------------------------- (2) Check the Appropriate Box if a Member of Group (See Instructions) [ ] (a) [ ] (b) ---------------------------------------------------------------------- (3) SEC Use Only ---------------------------------------------------------------------- (4) Citizenship or Place of Organization Bermuda ---------------------------------------------------------------------- Number of (5) Sole Voting Power 0 Shares Beneficially ------------------------------------------------------------- Owned by (6) Shared Voting Power 750,500 Each - Reporting ------------------------------------------------------------- Person (7) Sole Dispositive Power 0 With ------------------------------------------------------------- (8) Shared Dispositive Power 750,500 ---------------------------------------------------------------------- (9) Aggregate Amount Beneficially Owned by Each Reporting Person 750,500 ---------------------------------------------------------------------- (10) Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) ---------------------------------------------------------------------- (11) Percent of Class Represented by Amount in Row (9) 6.7% ---------------------------------------------------------------------- (12) Type of Reporting Person (See Instructions) OO --------------------------

CUSIP No. 0015351109 (1) Name of Reporting Person S.S. or I.R.S. Identification No. of Above Person Finsbury Worldwide Pharmaceutical Trust ---------------------------------------------------------------------- (2) Check the Appropriate Box if a Member of Group (See Instructions) [ ] (a) [ ] (b) ---------------------------------------------------------------------- (3) SEC Use Only ---------------------------------------------------------------------- (4) Citizenship or Place of Organization United Kingdom ---------------------------------------------------------------------- Number of (5) Sole Voting Power 0 Shares Beneficially ------------------------------------------------------------- Owned by (6) Shared Voting Power 750,500 Each - Reporting ------------------------------------------------------------- Person (7) Sole Dispositive Power 0 With ------------------------------------------------------------- (8) Shared Dispositive Power 750,500 ---------------------------------------------------------------------- (9) Aggregate Amount Beneficially Owned by Each Reporting Person 750,500 ---------------------------------------------------------------------- (10) Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) ---------------------------------------------------------------------- (11) Percent of Class Represented by Amount in Row (9) 6.7% ---------------------------------------------------------------------- (12) Type of Reporting Person (See Instructions) OO --------------------------

CUSIP No. 0015351109 (1) Name of Reporting Person S.S. or I.R.S. Identification No. of Above Person PHARMA/wHEALTH ---------------------------------------------------------------------- (2) Check the Appropriate Box if a Member of Group (See Instructions) [ ] (a) [ ] (b) ---------------------------------------------------------------------- (3) SEC Use Only ---------------------------------------------------------------------- (4) Citizenship or Place of Organization Luxembourg ---------------------------------------------------------------------- Number of (5) Sole Voting Power 0 Shares Beneficially ------------------------------------------------------------- Owned by (6) Shared Voting Power 750,500 Each - Reporting ------------------------------------------------------------- Person (7) Sole Dispositive Power 0 With ------------------------------------------------------------- (8) Shared Dispositive Power 750,500 ---------------------------------------------------------------------- (9) Aggregate Amount Beneficially Owned by Each Reporting Person 750,500 ---------------------------------------------------------------------- (10) Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) ---------------------------------------------------------------------- (11) Percent of Class Represented by Amount in Row (9) 6.7% ---------------------------------------------------------------------- (12) Type of Reporting Person (See Instructions) OO --------------------------

Item 1. Issuer (a) Alexion Pharmaceuticals, Inc. (b) 25 Science Park New Haven, CT 06511 Item 2. Persons Filing (a) Name of Persons Filing: OrbiMed Advisers Inc. OrbiMed Advisors LLC Worldwide Health Sciences Portfolio Finsbury Worldwide Pharmaceutical Trust Caduceus Trust PHARMA/wHEALTH (b) Address of Principal Offices: c/o OrbiMed Advisors Inc. 767 Third Avenue, 6th Floor New York, New York 10010 (c) Citizenship: Please refer to Item 4 on each cover sheet for each filing person (d) Title of Class of Securities: Common Stock (e) CUSIP Number: 0015351109 Item 3. Not Applicable Item 4. Ownership Please see Items 5, 6, 7, 8, 9, and 11 for each cover sheet for each filing entity. Item 5. Ownership of Five Percent or Less of a Class Not applicable. Item 6. Ownership of More than Five Percent on Behalf of Another Person Not applicable.

Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company Not applicable. Item 8. Identification and Classification of Members of the Group Not Applicable. Item 9. Notice of Dissolution of Group Not Applicable. Item 10. Certification By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect.

SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. Date: February 12, 1999 ORBIMED ADVISERS INC. By: /s/ Samuel D. Isaly ---------------------------- Name: Samuel D. Isaly Title: President ORBIMED ADVISORS LLC By: /s/ Samuel D. Isaly ---------------------------- Name: Samuel D. Isaly Title: Managing Member WORLDWIDE HEALTH SERVICES PORTFOLIO By: /s/ Samuel D. Isaly ---------------------------- Name: Samuel D. Isaly Title: Director CADUCEUS CAPITAL TRUST By: /s/ Deborah O'Donnel ---------------------------- Name: Deborah O'Donnel Title: Secretary

FINSBURY WORLDWIDE PHARMACEUTICAL TRUST By: /s/ Samuel D. Isaly ---------------------------- Name: Samuel D. Isaly Title: Director PHARMA/wHEALTH By:/s/ Samuel D. Isaly ---------------------------- Name: Samuel D. Isaly Title: Director