Terms and Conditions

(1) By using this copay card, you acknowledge that patient currently meets the eligibility criteria and will comply with the terms and conditions described below. (2) Patient must have a valid prescription for AMVUTTRA^®, GIVLAARI^®, ONPATTRO^®, OXLUMO^®. (3) Valid only for those with commercial insurance. (4) Program has an annual benefit cap. (5) Patient is responsible for any costs once limit is reached in a calendar year. (6) Program not valid (i) under Medicare, Medicaid, TRICARE, VA, DoD, Indian Health Services (IHS), or any other federal or state health care program, (ii) where patient is not using insurance coverage at all, (iii) where patient’s insurance plan reimburses for the entire cost of the drug, or (iv) where product is not covered by patient’s insurance. (7) The value of this Program is exclusively for the benefit of patients and is intended to be credited towards patient out-of-pocket obligations and maximums, including applicable co-payments, coinsurance, deductibles and any programs offered by a third party payer or pharmacy benefit manager, or an agent of either, that adjusts patient cost- sharing obligations, through arrangements that may be referred to as “accumulator” or “maximizer” programs. (8) Program is not valid where prohibited by federal and state laws. (9) Patient may not seek reimbursement for the value received from this Program from other parties, including any health insurance program or plan, flexible spending account, or health care savings account. (10) Patient is responsible for complying with any applicable limitations and requirements of their health plan related to the use of the Program. (11) Valid only in the United States and US territories. (12) This Program is not health insurance. (13) Program may not be combined with any third-party rebate, coupon, or offer. Proof of purchase may be required. (14) This copay card will be accepted only at participating pharmacies. (15) Patient must be 18 years of age or older to redeem the copay card. (16) Alnylam reserves the right to rescind, revoke, or amend the Program and discontinue support at any time without notice. (17) Data related to the redemption of the copay card may be collected, analyzed, and shared with Alnylam, for market research and other purposes related to assessing Alnylam's programs. Data shared with Alnylam will be aggregated and de-identified; it will be combined with data related to other copay card redemptions and will not identify patient. (18) Pharmacist Instructions: This card must be accompanied by a valid prescription for AMVUTTRA^®, GIVLAARI^®, ONPATTRO^®, OXLUMO^®. Please submit the copay authorized by patient’s primary insurance as a secondary transaction. Pharmacists with questions, please call CapitalRx at 1-844-306-9173.