All prescriptions for ORLYNVAH must be sent to Alto Pharmacy through your EHR or via fax to 415-484-7058. It is important to submit accurate patient, prescriber, and health plan information with the prescription.
ORLYNVAH is exclusively available through Alto Pharmacy
Iterum Therapeutics is committed to helping ensure your patients can access ORLYNVAH when they need it. Alto Pharmacy facilitates access and manages prescription orders for ORLYNVAH.
How to prescribe ORLYNVAH
All prescriptions for ORLYNVAH must be sent to Alto Pharmacy.
Search “Alto Pharmacy” by name or NPI (1417411513) in the EHR retail pharmacy finder to electronically send prescriptions
OR
Fax prescriptions to 415-484-7058
Once Alto Pharmacy receives the prescription, they manage fulfillment by confirming the patient’s coverage, coordinating with the health plan, and filling and shipping ORLYNVAH. Your patient will receive patient communications via text message from Alto Pharmacy to help guide them through next steps for accessing ORLYNVAH. If there is an urgent need for an expedited shipment of ORLYNVAH per your request, the patient will be notified of the expedited timeline for receiving their medication.
If you have questions or need help with sending a prescription to Alto Pharmacy, please call 800-874-5881.
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Alto Pharmacy completes the benefits investigation. They will contact you if a prior authorization (PA) or other documentation is required.
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If applicable, Alto Pharmacy reaches out to the provider and/or patient for additional information to complete a PA, medical exception, or appeal.
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Alto Pharmacy automatically applies copay support for eligible patients and notifies all patients of their financial responsibility for ORLYNVAH.
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Alto Pharmacy aims to fill and ship ORLYNVAH to the patient on the same day.*
Eligible patients may pay as little as $25 for ORLYNVAH
The ORLYNVAH Copay Program provides commercially insured patients with financial assistance for their out-of-pocket (OOP) costs. Please see terms and conditions below.
Iterum helps ensure ORLYNVAH reaches your patient at the earliest possible time and at the lowest possible price.
If your patient is eligible, copay support† is applied automatically to reduce their costs
Any remaining OOP costs are collected from the patient
Delivery of ORLYNVAH is scheduled with your patient at their preferred location and time
By utilizing the ORLYNVAH Copay Program, the patient acknowledges that they currently meet the eligibility criteria and will comply with the terms and conditions described below:
Subject to ORLYNVAH Copay Program limitations, terms, and conditions, the ORLYNVAH copay offer is available to patients who have a valid ORLYNVAH prescription and who have commercial insurance coverage for ORLYNVAH administered through a pharmacy benefit plan. Patients with commercial health insurance that does not provide formulary coverage for ORLYNVAH are NOT eligible for the copay offer.
Patients enrolled in any state or federally funded healthcare program, including but not limited to Medicare, Medigap, Medicaid, VA, DOD, TRICARE, Puerto Rico Government Health Insurance Plan, and Medicare-eligible patients enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees, are NOT eligible for the copay offer.
Uninsured and cash-paying patients are NOT eligible for the copay offer.
Eligible patients may pay as little as $25 on each 5-day supply. Annual benefit limits per individual apply and out-of-pocket expenses may vary. Patients are responsible for all amounts that exceed these copay offer benefit limits.
If prior authorization is required for ORLYNVAH coverage and approved by the commercial insurer, then the patient remains eligible for the copay offer. If prior authorization is denied by the commercial insurer, then the patient is no longer eligible for the Copay Program benefits.
Iterum Therapeutics US Limited (“Iterum”) has the right to reduce or eliminate patient benefit amounts, based on factors determined solely by Iterum, including the terms of a patient’s prescription drug plan and whether the plan uses all program funds for the benefit of the patient.
Data related to a patient’s receipt of Copay Program benefits may be collected, analyzed, and shared with Iterum and its affiliates for market research and other purposes related to assessing the Copay Program offer.
The ORLYNVAH Copay Program is restricted to residents of the United States. Patients residing in or receiving treatment in certain states may not be eligible.
This copay offer is intended for the benefit of patients, not their insurance plans or other third parties. Patients whose commercial insurance plans do not apply copay assistance payments to satisfy patient out-of-pocket cost sharing amounts may not be eligible for the Program.
The ORLYNVAH Copay Program is not health insurance. Patients may not seek reimbursement for the value received from the Program from any third-party payers, including a flexible spending account or healthcare savings account. Participating in this program means that you are ensuring you comply with any required disclosure regarding your participation in the Program of your insurance carrier or pharmacy benefit manager.
The ORLYNVAH Copay Program offer is void if copied, transferred, purchased, altered, or traded, and where prohibited and restricted by law and is not transferable. No substitutions are permitted. The Copay Program benefit cannot be combined with any other financial assistance program, free trial, discount, prescription savings card, or other offer.
Iterum and its affiliates reserve the right to make eligibility determinations, to set Program benefit maximums, and to change or discontinue this Program at any time without notice.
These Terms and Conditions are valid for ORLYNVAH dispensed between 08/15/2025 and 8/31/2026. Expiration Date: 08/31/2026.
Resources for your practice
Learn more about Alto Pharmacy and how to help patients get started with ORLYNVAH
Support medical exceptions and appeals with the help of Alto Pharmacy
Work with Alto Pharmacy to challenge an insurance decision against ORLYNVAH
Alto Pharmacy aims to deliver ORLYNVAH prescriptions to patients within 24 hours of receipt.
†The ORLYNVAH Copay Program can save eligible patients on their OOP medicine costs. Depending on the patient’s health insurance plan, savings may apply toward the copay, coinsurance, or deductible.
Who is right for ORLYNVAH?
Consider ORLYNVAH for patients like these
Convenient, at-home dosing
A one pill, twice-daily, 5-day oral treatment1