OXLUMO

Indicated For

Primary Hyperoxaluria Type 1 (PH1)

About This Medication

# Alnylam Assist® Patient Guide: How to Get OXLUMO at Low or No Cost ## About This Program The Alnylam Assist® Patient Assistance Program (PAP) is a free program created by Alnylam Pharmaceuticals to help patients who cannot afford OXLUMO (lumasiran) get access to this life-changing medication. OXLUMO is used to treat Primary Hyperoxaluria Type 1 (PH1), a rare genetic condition that causes the body to produce too much oxalate, leading to kidney stones and kidney damage. ## What Is OXLUMO? OXLUMO is an innovative RNA interference (RNAi) therapeutic—a type of advanced medication that works by reducing the production of oxalate in the liver. By lowering oxalate levels, OXLUMO helps prevent kidney stone formation and slow the progression of kidney disease in patients with PH1. This is typically administered as a once-monthly injection after an initial loading dose phase. ## Who Can Qualify? You may be eligible for Alnylam Assist® if you: - Have been diagnosed with Primary Hyperoxaluria Type 1 (PH1) - Are prescribed OXLUMO by your healthcare provider - Are a U.S. resident - Meet the program's income eligibility requirements - Are primarily uninsured or underinsured - Have insurance that doesn't adequately cover OXLUMO Note: Some patients with Medicare Part D coverage may also qualify. Check with the program directly about your specific insurance situation. ## Income Eligibility The Alnylam Assist® program uses flexible income guidelines that vary based on your household size. While exact thresholds may change, the program is designed to help a broad range of patients, including those with moderate incomes. The program uses a sliding scale, which means your out-of-pocket cost is based on what you can afford to pay. | Household Size | General Income Range* | |---|---| | 1 person | Varies by program guidelines | | 2 people | Varies by program guidelines | | 3 people | Varies by program guidelines | | 4 people | Varies by program guidelines | | 5+ people | Varies by program guidelines | *Income thresholds are flexible and may be higher for patients with significant medical expenses. Contact the program for current specific limits. ## Insurance Requirements The Alnylam Assist® program primarily serves patients who are: - **Uninsured** (no health insurance coverage) - **Underinsured** (insurance that doesn't cover OXLUMO adequately) - **Medicare Part D patients** (some may qualify; call to verify) If you have private insurance or Medicaid that covers OXLUMO, you should typically use that coverage first. However, if your insurance denies coverage or requires unaffordable out-of-pocket costs, you may still qualify for patient assistance. ## What Documents Do You Need? To apply for Alnylam Assist®, you will need: 1. **Completed Start Form** — This is the main application form that both you and your doctor must complete and sign. Your healthcare provider will confirm your PH1 diagnosis and OXLUMO prescription. 2. **Proof of Identity** — A valid government-issued ID (driver's license, passport, etc.) 3. **Income Verification** — Recent tax return, pay stubs, or a simple income attestation form 4. **Insurance Information** — Details about any current health insurance (if applicable) 5. **Prescription** — A valid, recent prescription for OXLUMO from your doctor ## Step-by-Step Application Instructions ### Step 1: Talk to Your Doctor Make an appointment with the healthcare provider who is treating your PH1. Discuss your financial situation and ask them to help you apply for patient assistance. Your doctor will need to complete and sign the Start Form confirming your diagnosis and that OXLUMO is medically necessary. ### Step 2: Request the Application Materials Visit **https://www.alnylamassist.com/oxlumo/financial-assistance** or ask your doctor's office to obtain the Alnylam Assist® application package. The Start Form and instructions will be available online or can be mailed to you. ### Step 3: Complete Your Portion of the Form Fill out all required fields in the application, including: - Your name, date of birth, and contact information - Household size and annual income - Current insurance information (if any) - Signature and date Be honest and accurate. Providing false information may result in denial and disqualification from the program. ### Step 4: Have Your Doctor Complete Their Portion Give the completed form to your healthcare provider. They will verify your diagnosis, confirm that OXLUMO is medically appropriate, and sign the form. This typically takes a few business days. ### Step 5: Submit Your Application You have multiple submission options: - **Mail**: Send the completed form and supporting documents by regular mail to the fax number listed (1-833-256-2747 can also receive applications) - **Online**: Visit the program website and upload your documents - **Through Your Doctor's Office**: Your healthcare provider may submit on your behalf Keep copies of everything you submit for your records. ### Step 6: Wait for Approval The program typically processes applications within **4 to 8 weeks**. You'll receive written notification of approval, conditional approval, or denial by mail or email. ### Step 7: Receive Your Medication Once approved, OXLUMO will be **shipped directly to you** (usually to your home or doctor's office). Most patients receive their first doses within 2-3 weeks of approval. ## What Happens If You're Approved? If your application is approved, you'll receive: - **Free or low-cost OXLUMO** based on your income and ability to pay - **Ongoing medication** delivered to your door - **Support from a case manager** who can answer questions and help with refills - **Education about your medication** and how to use it properly You do not need to requalify annually; the program will contact you when reauthorization is needed. ## What If Your Application Is Denied? If you don't qualify, you have several options: 1. **Ask for a Reconsideration** — If your circumstances have changed, you can reapply with updated information. 2. **Check for a Manufacturer Savings Card** — Alnylam may offer additional discounts through a savings card even if you don't qualify for full patient assistance. 3. **Contact Your Insurance Company** — Request an appeal if your insurance previously denied coverage. 4. **Speak with a Patient Advocate** — Ask your doctor or hospital social worker about other resources, including state programs and nonprofits that help with rare disease medications. 5. **Look Into State Programs** — Some states offer pharmaceutical assistance programs for residents with rare diseases. ## Timeline Summary - **Application Submission**: Day 1 - **Processing Time**: 4-8 weeks typical - **Approval Notification**: By mail/email - **Medication Delivery**: Within 2-3 weeks of approval - **Total Time from Application to First Dose**: Approximately 6-11 weeks ## Additional Resources - **Patient Assistance Website**: https://www.alnylamassist.com/oxlumo/financial-assistance - **National Organization for Rare Disorders (NORD)**: Offers information and support for PH1 patients - **American Kidney Fund**: Provides financial assistance for kidney disease patients - **NeedyMeds.org**: Database of patient assistance programs and other resources - **Your Healthcare Provider**: Your doctor or nurse can help coordinate the application process ## Important Legal Notice This guide is for informational purposes only and does not constitute medical or legal advice. The Alnylam Assist® program policies, income limits, and eligibility requirements may change at any time. Always visit the official program website or contact Alnylam Pharmaceuticals directly for the most current and accurate information. Patient assistance programs are subject to federal and state regulations. If you have questions about your eligibility or application status, contact the program directly at the website or phone number provided. --- **Remember**: You are not alone. Patient assistance programs exist specifically to help people like you access the medications they need. Don't hesitate to apply—the program wants to help you get OXLUMO so you can manage your PH1 effectively.

Program information last verified: March 25, 2026