Welcome to Zurampic® Savings Program


ELIGIBLE PATIENTS PAY AS LITTLE AS
$30* PER PRESCRIPTION FILL
Subject to Eligibility. Restrictions apply. See Eligibility, and Terms and Conditions for details.
Zurampic Savings Card
If you are eligible*, you may pay as little as $30 per prescription/fill with a ZURAMPIC® Savings Card.

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You certify that the information provided above is true and correct. In addition, by providing your email address, you agree with our Privacy Policy and would like to receive information in the future about ZURAMPIC and related health information.

Ironwood respects your personal health information and your privacy. The information you provide may be used to send you health-related materials on behalf of Ironwood or ZURAMPIC, or solicit your opinion and to develop products, services and programs. Certain information pertaining to your participation will be shared with Ironwood, the sponsor of the program. The information shared will include the date that you filled the prescription, the number of ZURAMPIC tablets dispensed by your pharmacist, and your savings under the program. Ironwood, or third parties working on Ironwood’s behalf, will not sell or rent personal health information. If in the future you no longer want to receive health-related materials, or to obtain a copy of our privacy statement, please contact us at ​optout@ironwoodpharma.com.

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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 one(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: 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, 8,3). Patient pays the first $30 plus any remaining balance after the maximum savings limit for the program is reached. Reimbursement will be received from Therapy First Plus. For any questions regarding online processing, call the Therapy First Plus Help Desk at 1-800-422-5604.

Program managed by COMP, LLC on behalf of Ironwood Pharmaceuticals.

Please see Medication Guide within full Prescribing Information, including BOXED WARNING.