Colcrys
Colcrys
Colcrys
COLCRYS (colchicine, USP) tablets are used to prevent and treat gout flares. The most common side effect in clinical trials for the prevention and treatment
COLCRYS can cause serious side effects in people with kidney or liver of gout was diarrhea.
problems who are taking medicines that interfere with COLCRYS. COLCRYS For more information, refer to the patient Medication Guide. This information is
can also cause serious muscle problems. You have a higher chance for not intended to replace discussions with a healthcare provider.
muscle problems if you are taking certain other medicines with COLCRYS.
Certain medicines when taken with COLCRYS can cause the levels of You are encouraged to report negative side effects of prescription drugs to the
COLCRYS to be too high in your body. Discuss any health problems you have, FDA. Visit www.fda.gov/medwatch or call 1.800.FDA.1088.
as well as medicines you are taking (including non -prescription medicines and You may also report negative side effects to the manufacturer of COLCRYS by
herbal supplements), with your healthcare provider before starting COLCRYS. calling 1.888.351.3786.
Submit claim to McKesson Corporation using BIN #610524. For pharmacy for reimbursement. Submit claim to McKesson Corporation. Offer not valid if
processing questions, please call the Help Desk at 1.800.657.7613. reproduced or submitted to any other payer. It is illegal for any person to sell,
purchase, or trade, or offer to sell, purchase, or trade, or to counterfeit, this
Void where prohibited by law. Product dispensed pursuant to terms and voucher. Prescriber ID# required on prescription. McKesson retains the right to
conditions of voucher. Claim shall not be submitted to any public or private review all records and documentation relating to the filling/dispensing of
third-party payer or any federal or state healthcare program product.
Limit 1 TrialScript ® voucher per patient Participation in this program must comply with all applicable laws and
contractual or other obligations as a pharmacy provider
Offer good only in the USA and Puerto Rico at participating retail
pharmacies and cannot be redeemed at government-subsidized This is not an insurance program
clinics Participating patients and pharmacists understand and agree to
Void where prohibited by law comply with the terms and conditions of this offer as set forth herein
Claim shall not be submitted to any public or private third-party payer Valid only with COLCRYS prescriptions written for 7 tablets
or any federal or state healthcare program for reimbursement This voucher offered in lieu of a sample
Offer cannot be combined with any other coupon, certificate, voucher, An original voucher and a valid 7 -tablet prescription must be
rebate, or similar offer presented; this voucher may not be sold, counterfeited, reproduced,
URL Pharma, Inc. reserves the right to rescind, revoke, or amend this replicated, or copied
offer without notice This voucher has no cash redemption value
RxBIN: 610524 RxGROUP: 50775527 ID: 896637408
RxPCN: Loyalty ISSUER: (80840) Expiration: 01/31/2012
Patient: You must present this coupon to the pharmacist along with your COLCRYS prescription to participate in this program. If you have any questions
regarding your eligibility or benefits, call the COLCRYS program at 1.800.657.7613 (8:00 am-8:00 pm EST, Monday -Friday). When you use this coupon,
you are certifying that you understand the program rules, regulations, and terms and conditions. You are not eligible if prescriptions are paid by any
state or other federally funded programs, including but not limited to Medicare or Medicaid, Medigap, VA or DOD or TriCare, or where prohibited by law;
and you will otherwise comply with the terms above.
COLCRYS (colchicine, USP) tablets are used to prevent and treat gout flares.
COLCRYS can cause serious side effects in people with kidney or liver problems who are taking medicines that interfere with COLCRYS. COLCRYS can
also cause serious muscle problems. You have a higher chance for muscle problems if you are taking certain other medicines with COLCRYS. Certain
medicines when taken with COLCRYS can cause the levels of COLCRYS to be too high in your body. Discuss any health problems you have, as well as
medicines you are taking (including non -prescription medicines and herbal supplements), with your healthcare provider before starting COLCRYS. The most
common side effect in clinical trials for the prevention and treatment of gout was diarrhea.
For more information, refer to the patient Medication Guide. This information is not intended to replace discussions with a healthcare provider.
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.
You may also report negative side effects to the manufacturer of COLCRYS by calling 1.888.351.3786.
Pharmacist: Limitations:
When you use this card, you are certifying that you have not submitted *Maximum savings of $75 per prescription.
and will not submit a claim for reimbursement under any federal, state,
or other governmental programs for this prescription. Patients not eligible if prescriptions are paid in part or full by any
Submit transaction to McKesson Corporation using BIN #610524 state or federally funded programs including but not limited to
Medicare or Medicaid, Medigap, VA, DOD, or TriCare, and where
Valid only for patients with primary coverage; input card information
prohibited by law
as secondary coverage and transmit using the COB segment of the
NCPDP transaction; applicable discounts will be displayed in the Valid only with COLCRYS prescriptions
transaction response Coupon may be used up to 12 times with a valid COLCRYS
Acceptance of this coupon and your submission of claims for the prescription
Not valid for cash -paying patients or rejected claims
COLCRYS program are subject to the LoyaltyScript ® program
Terms and Conditions posted at www.mckesson.com/mprstnc Void in Massachusetts and where prohibited by law
For questions regarding setup, claim transmission, patient
eligibility, or other issues, call LoyaltyScript ® for the COLCRYS
program at 1.800.657.7613 (8:00 am -8:00 pm EST, Monday -
Friday)