Krystexxa Patient Assistance Programs

Krystexxa: Apply for prescription assistance below

If you are eligible, the programs below can help you afford Krystexxa. Review the information to see if you qualify. The applications are available in Adobe PDF format and should be mailed directly to the provider of the patient assistance program.

If you have any questions, please call the telephone number for the program (not or go to the program website.

Looking for a different medication?

HealthWell Foundation Copay Program

(Program 1 of 2 — Scroll down to see them all )

Provided by: HealthWell Foundation
P.O. Box 489 Buckeystown, MD 21717
TEL: 800-675-8416
FAX: 800-282-7692
Languages Spoken:
English, Others By Translation Service
Program Website
  • Krystexxa (pegloticase)
Eligibility Requirements
  • Insurance Status May have insurance
  • Those with Part D Elibible? Yes
  • Income Varies
  • Diagnosis/Medical Criteria FDA Approved Diagnosis - See Program Website for Details
  • U.S. Residency Required? The patient must also be residing in the US.
  • Obtaining Call or complete online
  • Receiving Sent out or may be completed online
  • Returning The completed application must be mailed back.
  • Doctor's Action Complete section and sign
  • Applicant's Action Complete section, sign, attach a copy of proof of income
  • Decision Communicated Patient notified in writing
  • Decision Timeframe 3-5 business days
  • Amount/Supply Not applicable
  • Sent To Varies
  • Delivery Time Not specified
  • Refill Proces Good for one year
  • Limit Not specified
  • Re-application New application every 12 months
Additional Information
This program provides financial assistance to eligible individuals to cover coinsurance, copayments, healthcare premiums and deductibles for certain treatments. Also, for those who are eligible for health insurance, but cannot afford the insurance premium, the foundation may be able to help by paying some or all of the medical portion of insurance premiums. The patient is being treated for a specific disease for which funding is available and has insurance that covers the treatment for this disease. Call for most recent medications as the list is subject to change.
Updated April 1, 2019

Back to top

Horizon Cares

(Program 2 of 2 — Scroll down to see them all )

Provided by: Horizon Pharma USA, Inc.
TEL: 866-479-6742
Languages Spoken:
Program Website
Program Applications and Forms
  • Krystexxa (pegloticase)
Eligibility Requirements
  • Insurance Status Determined case by case
  • Those with Part D Elibible? Not specified
  • Income Determined case by case
  • Diagnosis/Medical Criteria FDA-approved diagnosis
  • U.S. Residency Required? Must be a US resident
  • Obtaining Call or download from Programs website
  • Receiving Faxed or downloaded from website
  • Returning Varies
  • Doctor's Action Varies
  • Applicant's Action Inform Doctor that he/she is in need
  • Decision Communicated Not specified
  • Decision Timeframe Not specified
  • Amount/Supply Varies
  • Sent To Not specified
  • Delivery Time Not specified
  • Refill Proces Not specified
  • Limit Not specified
  • Re-application Not specified
Additional Information
Co-payment assistance, reimbursement support, and patient assistance programs are available for eligible patients. Contact program for details.
Updated February 11, 2019

Back to top