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Annoyed and slowly going broke/compound meds

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Ulcerative Colitis
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Posted 5/20/2015 1:11 AM (GMT 0)
I'm fuming! Nothing works on me and now I'm going to be starting a steroid suppository of some sort that needs to be made by a special compounding pharmacy out in the burbs.

I'm annoyed because a) I'm not driving out there to pick up suppositories, so they need to be shipped which will take a few days b) they will cost $100 for a 30 day supply and my supposedly great teacher insurance doesn't cover a cent of it.

My doctor is away at a conference so this is all being done via email. Don't want to bother him with a boatload of questions right now. I'm really hoping that this wild and crazy compound suppository is just a short term thing because I'm not paying $100 a month for something that's going to go you know where.

Anyone ever heard of being on suppositories like this? If so, are they usually used long term or just to knock us out of a flare?
Posted 5/20/2015 2:31 AM (GMT 0)
If it's a steroid then you can't use it long term. When you get more details please let us know.
Posted 5/20/2015 2:53 AM (GMT 0)
i work for my health insurance company and have to meet my $1000 deductible annually before they'll drop to a copay of $150 so $100 a month doesnt sound too far off

I've spent about $10,000 out of pocket since December 2013 (9 day hospital stay, sigmoid, colonoscopy and meds) and have the best option plan available to me at work. this disease is draining financially

Is there a patient assistance program for your suppository? Sometimes they are out there, I know canasa has one

Good Luck, I feel your financial pain
Posted 5/20/2015 2:58 AM (GMT 0)
I will definitely provide more info when I get it, Gary. At this point I'm not even sure what this drug combo is made of.

I'm guessing that my insurance doesn't cover it because it's going to be a compound medicine that is being specifically made for me. It's not a name brand anything. Normally, my plan covers all but $20 of even the most expensive drugs...not this time! These suppositories had better be made out of unicorn powder for that out of pocket price. Also, I hope they work :-)
Posted 5/20/2015 3:13 AM (GMT 0)
I think it would depend on the ingredients. My GI has mentioned compounding entocort+canasa suppositories and I don't see why those couldn't be used for quite some time. Entocort is a form of steroid so you probably won't be using it LONG term... I don't see why this would be any more effective than using cortifoam + a canasa suppository, but I didn't ask that question. $100 isn't bad if insurance isn't covering anything. I know some people pay 500-1000 for canasa... I usually have a max on anything that's $50, i hate when something costs $50, that's a lot. I just hope it helps you quickly and you don't have to order it often.
Posted 5/20/2015 9:59 PM (GMT 0)
True that $100 isn't that bad...I was one of those people who used to pay much more for Canasa before I got my current insurance. I'm just annoyed because my insurance is supposedly great and I get nothing covered for this one.

Fun tidbit: I found out that these magic suppositories will be made of some combination of Uceris and something else. Sounds interesting. Hope it works!
Posted 5/20/2015 10:50 PM (GMT 0)
I think it's bs that your insurance won't pay. it's a medical necessity and if it's normally maxed at $20, they should give it to you at $20. You should appeal.
Posted 5/20/2015 10:59 PM (GMT 0)
If I recall correctly, Cortifoam costed me 130.00 for one cannister (14 day use) and yes, cortifoam is steroid based and can be used long term as I had been on it at one point for over a year including weening off of it.
Posted 5/20/2015 11:31 PM (GMT 0)
my CareMark plan in KS covered the medications in compounds, but not the cost of compounding.

when I was looking into getting LDN compounded, the med was only like 51 cents a dose, but the compounding was about $4 per dose. So that was $120/month that was not covered.

check out if your cost is meds or services.
Posted 5/21/2015 12:48 AM (GMT 0)
cortifoam is expensive for me too. It's $50 per pick up. Lately my GI has been writing it for a can a week or something so I get 4 at once, it's great. I used to get one can for $50, now I get 4 cans.
Posted 5/21/2015 1:40 AM (GMT 0)
I take 5 AsacolHD/day .... 90 day supply costs >$1800! pay in full until hitting my $3000 deductible then pay 30% til $5000 out of pocket max on all covered medical expenses paid. Now uninsured because spouse was laid off ... Cobra (self insuring for the 2 of us) is >$1100/month ... which totals (premium plus out of pocket max) about $20000 for one year- the top 1% wealthy in the U.S. really knows how to keep the rest of us from advancing/saving, well at least those of us who unfortunately get chronically sick.
Posted 5/21/2015 3:39 PM (GMT 0)
Uc prisoner, Look into patient assistance programs, in the resources thread at the top of the forum. Generics are available, Sulfasalazine is less than a $100 a month as your gastroenterologist for a prescription.
Posted 5/22/2015 10:17 AM (GMT 0)
I am definitely going to appeal this. I think I found an answer though. According this article Caremark (who runs the Chicago Public Schools script Program), has made it more complicated to get compound drugs covered. Patients must pay up front as I did and then jump through some hoops. Check it out:

http://www.iacprx.org/?page=CCIns161314
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