Most eligible commercially insured patients

ZURAMPIC Coupon Savings Card

Subject to eligibility. Restrictions apply. See eligibility, terms, and conditions of use.

With the ZURAMPIC Savings Program, eligible commercially insured patients pay as little as $30 per 30-day fill. Please see the full eligibility information below.

With the ZURAMPIC Savings Program, eligible commercially insured patients pay as little as $30 per 30-day fill. Please see the full eligibility information below.

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Full eligibility and use information for ZURAMPIC Savings Card Offer

Program Terms, Conditions, and Eligibility Criteria 1. This offer is valid only for patients 18 years of age or older and is restricted to residents of, and good only in, the United States and Puerto Rico, at participating pharmacies. 2. You may be eligible for this offer if you are insured by commercial insurance and your insurance does not cover the full cost of your prescription. 3. Patients who are enrolled in a federally or state funded prescription insurance program (including any state pharmaceutical assistance programs), are not eligible for this offer. This includes patients enrolled in Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DOD) programs or TriCare, patients who are Medicare eligible and enrolled in an employer-sponsored group waiver health plan or government-subsidized prescription drug benefit program for retirees, and patients in private indemnity or HMO insurance plans that reimburse you for the entire cost of your prescription drugs. 4. If you are enrolled in a state or federally funded prescription insurance program, you may not use this Savings Card even if you elect to be processed as an uninsured (cash-paying) patient. 5. This offer is not valid for cash-paying patients. 6. This offer is not health insurance and is valid for retail prescriptions only and is good for use only by eligible commercially insured patients with a valid prescription for ZURAMPIC® (lesinurad) at the time the prescription is filled by the pharmacist and dispensed to the patient. Depending on your insurance coverage, eligible patients may pay as little as $30 for each of up to twelve (12) prescription fills of ZURAMPIC. Each 30-day supply counts as 1 use. Check with your pharmacist for your copay discount. Maximum savings limit applies; patient out-of-pocket expense may vary. 7. Prescriptions must be filled before the program expires on 12/31/17. 8. Offer void where prohibited by law, taxed, or restricted. 9. This card is not transferable. The selling, purchasing, trading, or counterfeiting of this card is prohibited by law. 10. This card has no cash value and may not be used in combination with any other discount, coupon, rebate, free trial, or similar offer for the specified prescription. 11. This card expires December 31, 2017. 12. Ironwood reserves the right to rescind, revoke, or amend this offer, eligibility, and terms of use at any time without notice. 13. This offer is not conditioned on any past, present, or future purchase, including refills. 14. By redeeming this card, you acknowledge that you are an eligible patient and that you understand and agree to comply with the terms and conditions of this offer.

By enrolling in this program, you are consenting to the collection and use of certain personal information, including, your email address and elements of pharmacy claim information, and to receive periodic ZURAMPIC refill reminders and additional program messages. This information will be collected and used by service providers of ZURAMPIC in order to administer this program. This information is not provided to Ironwood Pharmaceuticals directly. If you do not consent, please do not enroll into the program.

For questions about this program, please call 1-855-348-0704.

Pharmacist Certification: When you redeem this card, you certify that you have not submitted and will not submit a claim for reimbursement under any federal, state, or other government programs for this prescription.

Pharmacist Instructions for a Patient with an Eligible Third-party Payer:
For Insured/Covered Patients:
Submit the claim to the primary Third-party Payer first, then submit the balance due to Therapy First Plus using BIN #004682 as a Secondary Payer COB with patient responsibility amount and a valid Other Coverage Code (eg, 8). If you receive a rejection due to PA, step-edit, or NDC block, submit Other Coverage Code of 3 (Secondary Claim). The patient’s out-of-pocket expense will be reduced up to the maximum savings limit for the program. Reimbursement will be received from Therapy First Plus. For any questions regarding Therapy First Plus online processing, call the Help Desk at 1-800-422-5604.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch or call 1-800-FDA-1088.

 

Limitations of Use for ZURAMPIC:

  • ZURAMPIC is not recommended for the treatment of asymptomatic hyperuricemia
  • ZURAMPIC should not be used as monotherapy

IMPORTANT SAFETY INFORMATION ABOUT ZURAMPIC

WARNING: RISK OF ACUTE RENAL FAILURE, MORE COMMON WHEN USED WITHOUT A XANTHINE OXIDASE INHIBITOR (XOI)

  • Acute renal failure has occurred with ZURAMPIC and was more common when ZURAMPIC was given alone
  • ZURAMPIC should be used in combination with an XOI

Contraindications:

  • Severe renal impairment (eCLcr less than 30 mL/min), end-stage renal disease, kidney transplant recipients, or patients on dialysis
  • Tumor lysis syndrome or Lesch-Nyhan syndrome

Warnings and Precautions:

  • Renal events: Adverse reactions related to renal function have occurred after initiating ZURAMPIC. A higher incidence was observed at the 400-mg dose, with the highest incidence occurring with monotherapy use. Monitor renal function at initiation and during therapy with ZURAMPIC, particularly in patients with eCLcr below 60 mL/min or with serum creatinine elevations 1.5 to 2 times the pre-treatment value, and evaluate for signs and symptoms of acute uric acid nephropathy. Interrupt treatment with ZURAMPIC if serum creatinine is elevated to greater than 2 times the pre-treatment value or if there are symptoms that may indicate acute uric acid nephropathy. ZURAMPIC should not be restarted without another explanation for the serum creatinine abnormalities. ZURAMPIC should not be initiated in patients with an eCLcr less than 45 mL/min
  • Cardiovascular events: In clinical trials, major adverse cardiovascular events (defined as cardiovascular deaths, non-fatal myocardial infarctions, or non-fatal strokes) were observed with ZURAMPIC. A causal relationship has not been established.

Adverse Reactions:

  • Most common adverse reactions with ZURAMPIC (in combination with an XOI and more frequently than on an XOI alone) were headache, influenza, blood creatinine increased, and gastroesophageal reflux disease

Indication and Limitations of Use for ZURAMPIC:

ZURAMPIC is a URAT1 inhibitor indicated in combination with an XOI for the treatment of hyperuricemia associated with gout in patients who have not achieved target serum uric acid levels with an XOI alone.

  • ZURAMPIC is not recommended for the treatment of asymptomatic hyperuricemia
  • ZURAMPIC should not be used as monotherapy

Please see full Prescribing Information, including Boxed WARNING and Medication Guide.

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Limitations of Use for ZURAMPIC:

  • ZURAMPIC is not recommended for the treatment of asymptomatic hyperuricemia
  • ZURAMPIC should not be used as monotherapy

IMPORTANT SAFETY INFORMATION ABOUT ZURAMPIC

WARNING: RISK OF ACUTE RENAL FAILURE, MORE COMMON WHEN USED WITHOUT A XANTHINE OXIDASE INHIBITOR (XOI)

  • Acute renal failure has occurred with ZURAMPIC and was more common when ZURAMPIC was given alone
  • ZURAMPIC should be used in combination with an XOI

Contraindications:

  • Severe renal impairment (eCLcr less than 30 mL/min), end-stage renal disease, kidney transplant recipients, or patients on dialysis
  • Tumor lysis syndrome or Lesch-Nyhan syndrome

Warnings and Precautions:

  • Renal events: Adverse reactions related to renal function have occurred after initiating ZURAMPIC. A higher incidence was observed at the 400-mg dose, with the highest incidence occurring with monotherapy use. Monitor renal function at initiation and during therapy with ZURAMPIC, particularly in patients with eCLcr below 60 mL/min or with serum creatinine elevations 1.5 to 2 times the pre-treatment value, and evaluate for signs and symptoms of acute uric acid nephropathy. Interrupt treatment with ZURAMPIC if serum creatinine is elevated to greater than 2 times the pre-treatment value or if there are symptoms that may indicate acute uric acid nephropathy. ZURAMPIC should not be restarted without another explanation for the serum creatinine abnormalities. ZURAMPIC should not be initiated in patients with an eCLcr less than 45 mL/min
  • Cardiovascular events: In clinical trials, major adverse cardiovascular events (defined as cardiovascular deaths, non-fatal myocardial infarctions, or non-fatal strokes) were observed with ZURAMPIC. A causal relationship has not been established.

Adverse Reactions:

  • Most common adverse reactions with ZURAMPIC (in combination with an XOI and more frequently than on an XOI alone) were headache, influenza, blood creatinine increased, and gastroesophageal reflux disease

Indication and Limitations of Use for ZURAMPIC:

ZURAMPIC is a URAT1 inhibitor indicated in combination with an XOI for the treatment of hyperuricemia associated with gout in patients who have not achieved target serum uric acid levels with an XOI alone.

  • ZURAMPIC is not recommended for the treatment of asymptomatic hyperuricemia
  • ZURAMPIC should not be used as monotherapy

Please see full Prescribing Information, including Boxed WARNING and Medication Guide.

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