Amvuttra

(vutrisiran)

0.5 ML vutrisiran 50 MG/ML Prefilled Syringe [Amvuttra]

NO BLACK BOX WARNING

Dosage & administration

* The recommended dosage of AMVUTTRA is 25 mg administered by subcutaneous injection once every 3 months.
* AMVUTTRA is for subcutaneous use only and should be administered by a healthcare professional.

drug label

Amvuttra prescribing information

Contact Medical Science Liaison Report Adverse Event

prior authorization

Amvuttra prior authorization resources

Most recent Amvuttra prior authorization forms

View By Payer

Verified: Sep 27, 2023Cigna - Amvuttra Prior Authorization Form

Verified: Sep 26, 2023Blue Cross Blue Shield of Michigan - Amvuttra Prior Authorization Form (Medical Benefit)

Verified: Sep 21, 2023Aetna - Amvuttra Prior Authorization Form

OTHERComplete Letter of Medical Necessity

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Benefits investigation

PDFAmvuttra Start Form

Amvuttra Start Form - Online

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financial assistance

Amvuttra financial assistance options

Co-pay savings program

commercial only

PDFAmvuttra Start Form

Amvuttra Start Form - Online

OTHEREnroll in Patient Savings Program

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Overview

Reduce patient OOP costs for drug (and occasionally for drug administration/infusion costs or drug-related test costs)

Patient benefit

A portion (or all) of patient OOP (deductible, copay), typically up to monthly and/or annual max

Patient eligibility

Patient must enroll or activate (may permit HCPs to enroll on patient’s behalf for HCP-administered drugs)
Generally, must have commercial insurance (rarely, may permit uninsured patients to use)
May never be used with government insurance

How to sign up

Cards may be downloadable digital cards or hard copies
Some pharmacos offer debit cards with pre-loaded copay benefit
Typically, available through multiple channels (e.g., rep to HCP to patient; pharmacy to patient; patient via website, Hub live agent, or copay vendor (live agent or IVR); patient and HCP via Hub enrollment form)
Some HCP-administered product programs permit HCPs to enroll on a patient’s behalf through via Hub form

Foundation programs

under insured

no insurance

goverment insurance

65+

PDFAmvuttra Start Form

OTHERPatient Assistance Program

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Overview

Charitable 501(c)(3) organizations provide direct cost-sharing and other support (e.g., travel, counseling) through disease-state funds to indigent patients on first-come first-served basis
These organizations may receive financial contributions from drug manaufacturers for particular disease-state funds that cannot provide funds directly to patients - the foundation must be independent/unaligned

Patient benefit

Patients apply for grants that cover a portion (or all) of their out-of-pocket costs (deductibles and co-pays) until the grant is exhausted

Patient eligibility

Patients must apply and meet eligibility criteria including income level (typically a multiple of federal poverty line), specific diagnosis, insurance status, etc.