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Update to cost rant: Balsalazide vs Lialda

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Ulcerative Colitis
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Posted 11/20/2014 5:18 PM (GMT 0)
I am going to ask my GI today about trying generic balsalazide. For one thing I would be taking 9 pills instead of 2 Lialda--correct me if I'm wrong. For a savings of almost $100 and month maybe I would do that!

I have search past posts and see that not everyone has had luck with the generic. Would it hurt to try and go back on Lialda if necessary?

My diagnosis was changed from UC to more like Crohn's when inflammation skipped from left side to transverse colon and I don't know where it is now but it still feels like the original sigmoid symptoms. So the best area for the release of mesalamine is in question.

What would you do? If I have to I could stay on Lialda and still not starve...
Posted 11/20/2014 5:39 PM (GMT 0)
If you are doing well I wouldn't upset the apple cart. If you think there might be definite room for improvement then you could try switching and see what happens. This doesn't seem to happen much but you could try asking the doctor for transitioning by taking a half dose of one and a half dose of the other and see what happens. The doc probably won't be for that but I actually think it is a great idea. If you get worse then you know it is a bad idea and can immediately switch back. If you get better then the only question would be are you better because you are taking both at the same time or would you even be better by dumping the Lialda altogether and just going with the other?
Posted 11/21/2014 1:44 AM (GMT 0)
Gary,
That is a great idea! I'll see if the GI can handle it, but I do understand. The appointment was cancelled by his office today, so I have till next week in case anyone else wants to comment.

Yes, there is room for improvement but I am not in abject misery like in a major flare. I have managed to avoid pred so shouldn't complain, but sometimes I want to try it and have a chance at better healing.
Posted 11/21/2014 6:24 PM (GMT 0)
Have you looked into the card that helps with the copay for Lialda?
Posted 11/22/2014 12:57 AM (GMT 0)
Lialda co-pay card probably does not apply to seniors with Medicare drug coverage. RE balsalazide for Crohn's colitis: my gastro, a sub-specialist in IBD treatment, sometimes prescribes brandname Colazal to treat it. It's the 5-ASA known to help left-sided UC; balsalazide is its generic. The 9 capsules daily (standard dose) is not a big deal if one takes them 3 X 3 with meals. Be sure to check your plan's 2015 formulary to see which IBD meds they will be supporting. / Old Hat (34 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 11/22/2014 2:14 AM (GMT 0)
CanadaDrugsOnline sells generic Lialda for $355 for 400. You pay, then you have your doc fax the script. Easy!
Posted 11/23/2014 3:11 AM (GMT 0)
The Canadian pharmacy I looked at costs a lot more than $355 for 400 Lialda. But the higher price is for name brand, not the generic. Others here have said that the country of manufacture is not clear with these generics. For now I will try to go with name brand.

As Old Hat and others have warned, savings cards do not always apply to people with US Medicare Part D. A discount would be available to me but it is based on income and I don't qualify (this year at least). I should be grateful for that.

And, yes, I have checked the formulary. Balsalazide is covered (still not cheap) and colazol is not.

Thanks for all the replies. It really helps me make the best decision.
Posted 11/23/2014 6:06 AM (GMT 0)
Does your formulary provide an appeals process in case of drug exclusions? Mine has covered 2/3 of  brandname cost after my doctor certified that I need this particular med. / Old Hat (34 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 11/24/2014 12:50 AM (GMT 0)
I get drugs from Canada because I cannot afford them in the USA.

I use planetdrugsdirect.com

And

Canadadrugpharmacy.com

I don't use generics of Asacol 400 mg or Canasa (meds I take) because while those pharmacies offer generics they aren't MEDICALLY known to be TRUE generics. I guess there is something called NOVO 5 asa in Canada that is supposed to be a generic of Asacol, but it's not supported by the Canadian pharmacy as far as I know.

http://www.cag-acg.org/uploads/cagletter_odpd11mar2009.pdf

If Lialda doesn't have a true generic I wouldn't get the ones offered overseas.

Of course it's your decision and maybe others have had good luck with these so called generics.

GOOD LUCK!!
Posted 11/24/2014 1:25 AM (GMT 0)
The generic Lialda from India is still $355 for 400...I just checked. But you can pay 30 times as much if you want the name brand from the US!

I was on balsaliside, and it didn't do as well for me as the generic Lialda. I'm not sure why people are hung-up about drugs from outside the US. The US is not the only country capable of good manufacturing practices. Our friends in India have good regs and have an interest in producing quality drugs for their population.

The US is the patsy in the world drug game...we are expected to pay an unreasonably high price for our meds, and every other country enjoys much, much lower prices. This example, where a generic is available outside, but not inside, the US, the problem manifests itself in the worst way.

Post Edited (07vNH) : 11/23/2014 6:28:03 PM (GMT-7)

Posted 11/24/2014 3:01 AM (GMT 0)
Generics may be cheaper, but the secondary components used to make them can cause problems for IBDers. That is the main reason to stick with brandname meds. Drugs need to be regulated to insure that they contain effective amounts of the active ingredient, etc. Check out Wellbutrin issues if you don't believe in this necessity; cardiac & epileptic-treating generics have also come under scrutiny for sub-par dosing, very scary. / Old Hat (34 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 11/25/2014 5:11 AM (GMT 0)
The appeals process is an option I hadn't thought of. Do I learn a lot here or what?

Saw the GI today and he did not have an opinion about Lialda vs balsalazide. I decided to give the generic a try. Lialda is not perfect, so who knows, I might get the same or better results. If not, I'll quickly return to Lialda. I can transition as suggested by garylousiville if I want.

He wrote the prescription for "mesalamine 400" and we will see how the pharmacy translates that. Mesalamine=balsalazide I suppose.

Thanks everyone as I enter another phase of "new normal"; first life with IBD and now life without work insurance!
Posted 11/26/2014 3:03 AM (GMT 0)
You can count on my empathy in that senior dept.! I spent much of my 1st yr in retirement haggling over insurance issues; TG longtime gastro was a faithful ally in getting my UC med covered because I am subject to anaphylaxis. / Old Hat (34 yrs with left-sided UC; presently in remission taking brandname Colazal)
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