Help your patients access GIVLAARI® (givosiran) with Alnylam Assist®
To make the process convenient for your patient, Alnylam Assist® provides 3 separate options
for initiating and completing the Start Form.
Electronic Start Form
Complete and submit the Electronic Start Form online with your patient
Downloadable Start Form
Print, complete with your patient, then fax the Start Form to 1-833-256-2747
What happens next:
Your patient's dedicated Case Manager will reach out to you and your patient within 1-2 business days of receiving a completed Start Form
The Alnylam Assist® team will facilitate acquisition of GIVLAARI for your patient via specialty distributor or specialty pharmacy
Alnylam Assist® provides personalized support for your patients throughout the treatment process
A dedicated Case Manager
Alnylam Assist® will connect patients with a dedicated Alnylam Case Manager who can provide personalized support throughout the GIVLAARI treatment process.
Disease and product education
Patient Education Liaisons (PELs) are available to help educate patients and their families on acute hepatic porphyria.
Coverage for GIVLAARI will vary by plan and by patient. Alnylam Assist® can help determine patient-specific coverage requirements.
Eligible patients* may qualify for the Alnylam Assist® Quick Start Program, Patient Assistance Program (PAP), or Commercial Copay Program.
Field Reimbursement Directors (FRDs) can help provide education about the GIVLAARI reimbursement process, including the process for prior authorizations, claims, and appeals. They can also help explain billing and coding, chart documentation, and payer requirements for GIVLAARI.
Monday–Friday, 8AM–6PM ET
: 1-833-256-2748 | : 1-833-256-2747
*Patients must meet specified eligibility criteria to qualify for assistance. Alnylam reserves the right to make eligibility determinations and to modify or discontinue the program at any time.