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Colonoscopy -- New Diagnosis -- Alternatives to Lialda

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Ulcerative Colitis
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Posted 5/8/2015 6:30 PM (GMT 0)
I was diagnosed with UC (had UP before) and the doctor gave my wife an RX for Lialda #120 pills a month.   Looking it up online, I saw that this number of pills would be close to $1000 a month.  

I have told my doctor at least four times that I need generic or cheaper alternatives if possible.   Can anyone recommend a lower cost generic that functions the same as Lialda so I can discuss it with his office?   Is Balsalazide similar?  Comparable?   The cost is still ridiculous, but not $1000 ridiculous. 
Posted 5/8/2015 6:35 PM (GMT 0)
Not 100% sure of alternatives...maybe Asacol? I do know that Lialda has a pretty effective savings card that you can sign up for on their website. Also, I bet that your doctor could give you some samples. When I was a broke grad student, my doctor opened up his cabinets and filled my purse.
Posted 5/8/2015 6:54 PM (GMT 0)
NOt sure. I'm not a broke college student. We're comfortably middle class, but $1000 a month is absolute insanity.
Posted 5/8/2015 7:06 PM (GMT 0)
Do you have medical insurance? The price you find online is not the price you will pay at the pharmacy, most likely.

But yes, these name brand meds can be expensive. I spent close to $1000 per month in the first few years of my diagnosis. Now almost everything I take is generic and I'm down to about $200 per month. You can see my list of meds in my signature.

I suggest you talk to your DR about generic balsalazide. This costs me $10 per month. If you don't like your prescription plan, next year you can change.
Posted 5/8/2015 7:17 PM (GMT 0)
Sulfazine
Posted 5/8/2015 8:12 PM (GMT 0)
Balsalazide (brandname colzal) and Sulfazine are the only generic rough equivalents to lialda (melamine) in the usa.

Sulfazine is less than $100 a month, it's an older uc drug that carries more potential side effects. If you have a known sulfa allergy then avoid sulfazine.

Balsalazide is the generic to colzal. It's more expensive than sulfazine but has less side effects.

Other than those, order generic meslamine from canada.

There are patient assistance programs for lialda, apriso, colzal, and other brandnames in the usa. Lowers copays to $10 a month.
Posted 5/8/2015 9:19 PM (GMT 0)
The patient assistance programs are actually need based. There are manufacturer discount programs that are not need based, and they claim to lower copay to $10, but that is misleading. For example the Lialda card contributes upto $120 towards copay. You have to pay $10, so it only pays the full $120 if your copay is $130 or larger. Unfortunately if your copay is $350, you still pay $230.

You may want to consider an insurance plan that covers UC drugs. Today it is Lialda, but in the future it could be mesalamine enemas, and the sulfate-free version of those is even more expensive than Lialda.

Someone could skip mesalamines, and ask for a generic immune suppressant like 6mp, but it takes a while to work and has the baggage of an immune suppressant.

If this flare really gets ugly, it is possible that hospitalization and/or IV biologic drugs will be needed - and that can cost tens of thousands w/o insurance.
Posted 5/9/2015 1:56 AM (GMT 0)
The price I found is my cost via my health insurance with discounts. I'm going to check out my options for open enrollment, but typically the best for our overall needs is an HDHP plan, which has the drawback of paying nothing up front and requiring you to stock an HSA with personal cash. EVentually I'll meet my deductible, but every year I'll have that wonderful gap to fill with funds I won't have replenished (since you can't pay for drugs on a payment plan).

RANT: It bothers me that doctors don't realize that people no longer have decent RX plans (or none at all) and don't listen to you when you tell them you need to work to find the cheapest best alternative for medication. I have told my doctor several times in the past that this is the case, and I think they assume you're kidding.
Posted 5/9/2015 4:52 AM (GMT 0)
I think with your wife's chronic illness (UC is chronic, don't kid yourself) a HDHP plan is not going to be your best solution, even with an HSA.
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