LIVMARLI

Indicated For

Cholestatic pruritus in Alagille syndrome, Cholestatic pruritus in Progressive Familial Intrahepatic Cholestasis (PFIC)

About This Medication

# Mirum Patient Assistance Program (PAP) Patient Guide: How to Get LIVMARLI (maralixibat) at Low or No Cost LIVMARLI (maralixibat) oral solution is a prescription medication used to treat cholestatic pruritus (itching) in patients 3 months of age and older with **Alagille syndrome (ALGS)**, and to treat cholestatic liver disease in patients 1 year of age and older with **progressive familial intrahepatic cholestasis (PFIC)**.[1][2] The **Mirum Patient Assistance Program (PAP)** from Mirum Pharmaceuticals provides LIVMARLI **at no cost** for up to one calendar year to eligible uninsured patients or those whose insurance coverage has been denied, with annual eligibility review.[1][8] ## Who Qualifies for the Program? The Mirum PAP is designed for patients who face barriers to accessing LIVMARLI due to lack of insurance or denied coverage. Key eligibility criteria include: - **Uninsured patients** or those with **insurance coverage denied** (such as after prior authorization denial or appeal failure).[1][8] - Eligibility is **determined by the Mirum Access Plus team**, who review applications case-by-case. There are no publicly specified income thresholds like Federal Poverty Level (FPL) percentages; instead, the focus is on insurance status and medical need.[1][8] - Patients must reside in the **US or Puerto Rico** and have a valid prescription from a licensed healthcare provider.[6] - Exceptions may apply for certain insurances like TRICARE.[8] This program is part of the broader **Mirum Access Plus** support services, which help navigate access, but PAP specifically targets free medication for those without coverage options.[1][2] ## About LIVMARLI (maralixibat) **LIVMARLI** is an ileal bile acid transporter (IBAT) inhibitor that works by reducing bile acids in the liver, helping to relieve severe itching caused by cholestasis—a buildup of bile in the liver—in conditions like ALGS and PFIC.[1] These rare genetic disorders affect liver function, leading to intense pruritus that can impact sleep, skin, and quality of life. Clinical details like serum bile acid levels and prior treatment history are often documented to support prescriptions.[4] Common side effects include diarrhea, abdominal pain, and fatigue, but benefits for itch reduction are significant for many patients. Always discuss with your doctor if LIVMARLI is right for you. **~94% of patients get insurance approval, and 98% pay $10 or less per fill** through related programs, but PAP ensures no-cost access when needed.[1] ## Income Eligibility Breakdown Unlike many assistance programs with strict FPL limits (e.g., 400-500% of FPL), **Mirum PAP does not list specific income thresholds**. Eligibility centers on being uninsured or coverage-denied, with the Mirum Access Plus team assessing overall need.[1][8] This flexible approach helps more patients in rare disease communities. | Household Size | Income Threshold | Notes | |---------------|------------------|-------| | Individual | Not specified | Determined case-by-case by Mirum team[1] | | Couple | Not specified | Focus on uninsured/denied status[8] | | Family of 3 | Not specified | Annual review required[1] | | Family of 4+ | Not specified | US/Puerto Rico residents only[6] | If you have commercial insurance, consider the **Mirum Access Plus Savings Program** (as low as $10/fill) before PAP.[1] ## Insurance Requirements - **Must be uninsured** or have **documented coverage denial** (e.g., PA rejection, appeal failure).[1][4][8] - **Medicare patients**: May qualify if coverage is denied; team assesses eligibility.[8] - **Commercial/private insurance**: Explore savings first; PAP for denials.[1] - LIVMARLI is covered by **100% of plans as of 1/1/2023**, but denials happen—Mirum helps with appeals.[1] ## Step-by-Step Application Process 1. **Talk to your doctor**: They confirm diagnosis (e.g., ALGS/PFIC), pruritus severity, lab results (like serum bile acids), and prior treatments.[4] 2. **Enroll in Mirum Access Plus**: Patients text **MIRUM to 47936**, call **1-855-676-4968** (Mon-Fri, 8AM-8PM ET), or download/sign the Consent Form (English/Español).[2] 3. **Complete Patient Enrollment Form**: Your healthcare professional (HCP) fills required fields (*marked with asterisk*), including prescription, clinical history, and insurance info (front/back of card).[1][3][4] 4. **Fax to 1-855-282-4884**: Include form, insurance copy (if applicable), and patient demo from EMR. eRx possible via Eversana specialty pharmacy.[1][3] 5. **Consent to services**: Opt-in for texts/mobile app for tracking, reminders.[1][2][3] 6. **Mirum reviews**: Team determines PAP eligibility, handles payer follow-up if needed.[1][4] Your **Mirum Access Plus Coordinator** guides you, providing education and referrals.[2] ## Timeline and Delivery - **Processing time**: Not specified; aims for quick access. Track via mobile app/texts.[1][2] - **Approval**: Case-by-case; if denied coverage, team refers to PAP.[4][8] - **Delivery**: Shipped **directly to your home** from specialty pharmacy at no cost.[1] - **Duration**: Up to **1 calendar year**, then re-enroll.[1][8] - **Reauthorization**: Required annually or as needed; HCP completes form again.[1] ## Alternatives if Denied - **Appeal denial**: Mirum assists with peer-to-peer or formal appeals.[4] - **Savings Program**: For commercial insurance, $10/fill.[1] - **QuickStart** (related programs): Temporary supplies during delays (up to 60 days).[6] - **Other resources**: Outside referrals via Mirum; check RxAssist or state programs.[9] - No biosimilars available; LIVMARLI is unique for ALGS/PFIC.[ ] ## Important Disclaimer This guide is for informational purposes only and based on publicly available program details as of latest updates. **Eligibility, terms, and availability can change**; always verify with Mirum at 1-855-676-4968. Not a substitute for medical advice—consult your HCP. Program subject to terms/conditions; exceptions apply (e.g., TRICARE). Mirum Pharmaceuticals does not guarantee approval.[1][8] Word count: 1028.

Program information last verified: March 25, 2026