Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  

Ironwood Patient Assistance Program

This program provides brand name medications at no or low cost

Provided by: Ironwood Pharmaceuticals, Inc.

c/o Cardinal Health Specialty Solutions
2730 S Edmonds Lane
Suite 300
Lewisvile, TX 75067

TEL: 833-557-2413

FAX: 844-373-8785
Languages Spoken:

English, Others By Translation Service

Program Website


Program Applications and Forms

Ironwood Patient Assistance Program Enrollment Form



  • allopurinol/lesinurad (Duzallo) 

Eligibility Requirements   

Insurance Status Must be uninsured or underinsured
Those with Part D Eligible? Determined case by case
Income At or below 300% of FPL
Diagnosis/Medical Criteria FDA-approved diagnosis
US Residency Required? Must be citizen or legal resident


Obtaining Call or download
Receiving Faxed or downloaded from website
Returning Fax or Mail. (Note: faxed prescriptions are only valid if faxed directly from a prescriber's office. Submit COPIES of Proof of Household income documents. Do not mail original income or tax documents. Documents submitted can not be returned.)
Doctor's Action Complete section, sign, attach required documents
Applicant's Action Complete section, sign, attach required documents
Decision Communicated Patient and Doctor are notified
Decision Timeframe 2-4 business days


Amount/Supply Up to 30 day supply
Sent To Patient's home, unless otherwise noted
Delivery Time Within a week
Refill Process Patient must contact company
Limit One year
Re-application Must re-enroll at end of calendar year

Additional Information

Updated October 18, 2018