OXLUMO

Indicated For

Primary Hyperoxaluria Type 1 (PH1)

About This Medication

# Alnylam Assist® Patient Assistance Program (PAP) Patient Guide: How to Get OXLUMO (lumasiran) at Low or No Cost This guide explains how the **Alnylam Assist® Patient Assistance Program (PAP)** can provide **OXLUMO (lumasiran)** at no cost to eligible patients. It covers eligibility, the application process, and support resources in simple terms to help you access treatment for primary hyperoxaluria type 1 (PH1). ## About OXLUMO (lumasiran) **OXLUMO** is a prescription medicine used to treat primary hyperoxaluria type 1 (PH1) in adults and children 1 year of age and older. PH1 is a rare genetic disorder where the body produces too much oxalate, leading to kidney stones, kidney damage, and potentially kidney failure. OXLUMO works by reducing oxalate production in the liver through subcutaneous injections given every 3 months after initial loading doses. It's administered by a healthcare professional at a treatment site. Always consult your doctor for personalized advice on whether OXLUMO is right for you. This guide focuses on financial assistance, not medical details. ## Who Qualifies for the Program? The **Alnylam Assist® PAP**, run by **Alnylam Pharmaceuticals**, offers OXLUMO at no cost primarily to **uninsured patients** who meet financial eligibility criteria. Specific income thresholds are not publicly published, so eligibility is assessed case-by-case by an Alnylam Case Manager. Medicare Part D patients may also qualify—contact the program for details. You must have a valid prescription for OXLUMO to treat PH1 (ICD-10 code E72.530). ### Income Eligibility Breakdown Since exact income limits aren't disclosed, here's a general overview based on similar programs. Call (833) 256-2748 for your situation: | Household Size | Typical FPL % Range (Estimate) | Notes | |---------------|-------------------------------|-------| | Individual | Not specified | Primarily uninsured; financial docs required | | Couple | Not specified | Case-by-case review | | Family of 3 | Not specified | Focus on uninsured status | | Family of 4+ | Not specified | Medicare Part D may qualify | **Key Point**: Income requirements are not published; the program prioritizes uninsured patients. An Alnylam Case Manager proactively assesses eligibility after your doctor submits a Start Form. ## Insurance Requirements - **Primary Eligibility**: Uninsured or rendered uninsured patients. - **Medicare Part D**: Patients may be eligible—call to confirm. - **Commercial Insurance**: Consider the Alnylam Assist® Copay Program instead for out-of-pocket costs. - **Bridge Program**: Available for coverage delays or changes. If insured, explore other Alnylam options like the Copay Program or independent foundations via Alnylam Assist® dashboards. ## Step-by-Step Application Process 1. **Talk to Your Doctor**: Discuss OXLUMO for PH1 treatment. Your doctor completes the **Start Form** (pages 1-2), including patient info, insurance details, prescription (with DAW if needed), and signatures. 2. **Submit the Start Form**: - **Online**: Doctor and patient complete together at www.alnylamassist.com/hcp/oxlumo/webform (electronic consent required). - **Fax**: Fax signed pages 1-2 to 1-833-256-2747. - Multiple methods available. 3. **Alnylam Case Manager Contacts You**: Within **2 business days**, they reach out to you and your doctor. They'll verify benefits, assess PAP eligibility, and request financial documentation. 4. **Provide Required Documents**: - Financial documentation (e.g., tax returns, pay stubs—details provided by Case Manager). - Physician prescription via Start Form. - State NPI (National Provider Identifier). 5. **Eligibility Review**: Case Manager determines if you qualify for free OXLUMO. 6. **Approval and Next Steps**: If approved, medication ships to your provider or treatment site. Case Manager coordinates site selection based on preferences and coverage. Call **(833) 256-2748** (8am-6pm ET, Mon-Fri) for help anytime. ## Timeline and Delivery - **Start Form Processing**: Contact within 2 business days. - **Full Approval**: Varies; Case Manager handles proactively—no fixed processing time listed. - **Delivery**: Shipped directly to your provider or designated treatment site (e.g., infusion center). Field Reimbursement Team helps select sites. Regular check-ins occur before/after treatments. Patient Education Liaisons (PELs) offer disease education and support. ## Alternatives if Denied - **Copay Program**: For commercial insurance out-of-pocket costs (auto-enrolled via Start Form). - **Bridge Program**: Free medication during coverage delays. - **Independent Foundations**: Access dashboards on Alnylam Assist® for 501(c)(3) organizations. - **Other PAPs**: Check PAN Foundation or RxAssist.org. - **No Biosimilars**: None available for OXLUMO. Reapply if circumstances change or appeal with Case Manager. ## Important Disclaimer This guide is for informational purposes only and based on publicly available program details as of 2026. Eligibility, terms, and availability can change—always verify with Alnylam Assist® at (833) 256-2748 or alnylamassist.com. Not medical advice; consult your healthcare provider. Alnylam Pharmaceuticals reserves the right to modify the program. Patient data shared per Start Form authorizations for support services.

Program information last verified: March 29, 2026