1-833-256-2748
M
-
F
,
8
am -
6
pm ET
Call an Alnylam Assist® Case Manager

Forms and Documents

Below, you can find materials about Alnylam Assist™ and treatment with ONPATTRO® (patisiran).
If you have any questions, call Alnylam Assist™ at: at 1-833-256-2748 (Monday – Friday, 8am - 6pm).

Coverage, Coding, and Reimbursement

ONPATTRO Access & Reimbursement Kit › ONPATTRO Billing & Coding Guide - Hospital Outpatient › ONPATTRO Billing & Coding Guide - Physician Office › ONPATTRO Copay Reimbursement Submission Guide ›ONPATTRO Product Characteristics Sheet ›ONPATTRO Provider Readiness Guide ›ONPATTRO Reimbursement Guide ›

Resources for Patients and Caregivers

Alnylam Assist™ Brochure (for patients) › Alnylam Assist™ Caregiver Brochure › ONPATTRO Patient Brochure ›

Sample Letter of Medical Necessity

Sample Letter of Medical Necessity ›

This sample letter template is provided for informational purposes only. It provides an example of the form and types of information that may be provided when responding to a request from a patient’s insurance company to provide supporting clinical documentation or a letter of medical necessity for ONPATTRO. Use of the information in this letter does not guarantee that the health plan will provide reimbursement for ONPATTRO and is not intended to be a substitute for or to influence the independent medical judgment of the physician.

Who makes up the Alnylam Assist™ team?

The Alnylam Assist™ team consists of a Case Manager, a Field Reimbursement Director (FRD), and a Patient Education Liaison (PEL). Find out more about the Alnylam Assist™ team ›

Alnylam Assist® - Questions Icon

Find answers to other

Frequently Asked Questions ›

Enrolling Your Patients

Together with your patient
(in office)

Alnylam Assist® electronic Start Form icon

Electronic Start Form

Begin Here ›

or

Alnylam Assist® Start Form - To Print And Fax

Print
& Fax

Download Form ›

Initiate then send to patient
(via email)

Alnylam Assist® Start Form - To Email To Patient

DocuSign eSignature

Begin Here ›

HCP triangle

IMPORTANT SAFETY INFORMATION

Infusion-Related Reactions

Infusion-related reactions (IRRs) have been observed in patients treated with ONPATTRO® (patisiran). In a controlled clinical study, 19% of ONPATTRO-treated patients experienced IRRs, compared to 9% of placebo-treated patients. The most common symptoms of IRRs with ONPATTRO were flushing, back pain, nausea, abdominal pain, dyspnea, and headache.

To reduce the risk of IRRs, patients should receive premedication with a corticosteroid, acetaminophen, and antihistamines (H1 and H2 blockers) at least 60 minutes prior to ONPATTRO infusion. Monitor patients during the infusion for signs and symptoms of IRRs. If an IRR occurs, consider slowing or interrupting the infusion and instituting medical management as clinically indicated. If the infusion is interrupted, consider resuming at a slower infusion rate only if symptoms have resolved. In the case of a serious or life-threatening IRR, the infusion should be discontinued and not resumed. 

Reduced Serum Vitamin A Levels and Recommended Supplementation

ONPATTRO treatment leads to a decrease in serum vitamin A levels. Supplementation at the recommended daily allowance (RDA) of vitamin A is advised for patients taking ONPATTRO. Higher doses than the RDA should not be given to try to achieve normal serum vitamin A levels during treatment with ONPATTRO, as serum levels do not reflect the total vitamin A in the body.

Patients should be referred to an ophthalmologist if they develop ocular symptoms suggestive of vitamin A deficiency (e.g. night blindness).

Adverse Reactions

The most common adverse reactions that occurred in patients treated with ONPATTRO were upper respiratory tract infections (29%) and infusion-related reactions (19%).

INDICATION

ONPATTRO is indicated for the treatment of the polyneuropathy of hereditary transthyretin-mediated amyloidosis in adults.

For additional information about ONPATTRO, please see the full Prescribing Information.