Extending Access to COLCRYS (colchicine, USP)

COLCRYS has formulary coverage at the lowest branded co-pay tier with no restrictions for more than 80%^* of insured patients nationwide. Insured patients are intended to show size of insured population and not imply disease prevalence or appropriate population for treatment with COLCRYS. The following programs are designed to help patients get access to COLCRYS.

^*Fingertip Formulary, September 2012

Co-pay Assistance Program

Eligible privately insured patients pay only $15 per prescription^† with a Co-pay Coupon
Redeemable up to 12 times per year (once per month)
Print a money-saving coupon

FREE 7-Tablet Voucher

Patients have access to a FREE 7-tablet voucher for COLCRYS^‡
Eligibility Requirements: This voucher cannot be used if you are a beneficiary of or any part of your prescription is covered by: (1) any federal or state healthcare program (Medicare, Medicaid, TriCARE, etc.), including a state pharmaceutical assistance program, or (2) the Medicare Prescription Drug Program (Part D), or if you are currently in the coverage gap, or (3) a claim will be submitted to any payor for reimbursement.
Physician Instructions: To use this voucher, your patient needs one prescription for up to 7 tablets of COLCRYS.
Print a FREE voucher

Patient Assistance Program (PAP)

The Patient Assistance Program provides COLCRYS for a reduced price or even FREE to qualifying patients. To find out more or to download an application, please visit www.TakedaHelpAtHand.com or call 1-800-830-9159.

Program Eligibility

You are eligible to apply for the Takeda Patient Assistance Program if:

You are a legal resident of the United States.
You do not have prescription coverage through private or government programs. (If you are eligible for or enrolled in Medicare Part D, you may still apply – see application for guidelines.)
You can provide your household's proof of income and are able to pay a reduced copayment (if applicable). See Payment Calculator and Payment Method below.

Payment Calculator and Payment Method
Select your household size from the first column. Household size equals you, your spouse, and your dependents. Go across the row until you find your household income level. If your income is more than the income listed in the last column, you may not qualify at this time.
Household size	30-day supply is free if yearly income is less than^**:	30-day supply reduced price of $5 if yearly income is^††:	30-day supply reduced price of $25 if yearly income is^‡‡:	You may not qualify if yearly income is more than:
1	$33,510	$33,511-$44,680	$44,681-$67,020	$67,020
2	$45,390	$45,391-$60,520	$60,521-$90,780	$90,780
3	$57,270	$57,271-$76,360	$76,361-$114,540	$114,540
4	$69,150	$69,151-$92,200	$92,201-$138,300	$138,300
5	$81,030	$81,031-$108,040	$108,041-$162,060	$162,060

^*Patients with health insurance in the Fingertip Formulary database. Fingertip Formulary data as of January 26, 2012. This includes patients with commercial, Medicare Part D, or Medicaid prescription benefits.

^†Maximum savings $75 per prescription. Must meet eligibility requirements. See complete terms and conditions on coupon. This offer cannot be used if you are a beneficiary of, or any part of your prescription is covered by (1) any federal or state healthcare program (Medicare, Medicaid, TriCARE, etc.), including a state pharmaceutical assistance program, (2) the Medicare Prescription Drug Program (Part D), or if you are currently in the coverage gap, or (3) insurance that is paying the entire cost of the prescription.

^‡See complete terms and conditions on voucher.

^**60-day and 90-day supplies are also available at no cost

^††60-day supply payment is $10, 90-day supply payment is $15

^‡‡60-day supply payment is $50, 90-day supply payment is $75

USE OF COLCRYS

COLCRYS (colchicine, USP) 0.6 mg tablet is a prescription medicine used in adults to prevent and treat gout flares.

COLCRYS is not a pain medicine and should not be taken to treat pain related to other conditions.

Individual results may vary.

Important Safety Information

COLCRYS can cause serious side effects or death if levels of COLCRYS are too high in your body. Taking certain medicines with COLCRYS can cause your level of COLCRYS to be too high, even at recommended doses, especially if you have kidney or liver problems.
Tell your healthcare provider about all your medical conditions and all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements, and if you consume grapefruit juice.
Fatal overdoses, both accidental and intentional, have been reported in adults and children who have ingested colchicine. Keep COLCRYS out of the reach of children.
COLCRYS can also cause serious muscle problems and blood disorders even when taken as directed. You have a higher chance for muscle problems if you are elderly, are taking certain other medicines with COLCRYS, or have kidney problems.
Tell your healthcare provider if you have any side effect that bothers you or that does not go away.
The most common side effects in people who have gout flares are diarrhea (23%) and throat pain (3%).

For further information, please talk to your healthcare provider and see full Prescribing Information and Medication Guide

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.