Asacol ins. issues and can't use Lialda

Like many of you, my insurance decided to stop insurance coverage for Asacol. I've been on Asacol and Asacol HD for many years without problems. However, my doc tried changing me to Lialda. 5 days after starting it, I had severe vertigo as well as nausea and enough gut upset that I was sure I was going to start seeing blood very soon (its been a couple years since I noticed bleeding). He was going to try getting it covered under medical necessity, but I know how insurances can get with that and can't deal with a fight whenever it comes up for renewal - if they even agree. Besides, I'm sure they would make the price prohibitive.

I was hoping someone here could give other suggestions.

Direct delayed-release coated mesalamine equivalents are Apriso, Delzicol (which is asacol inside a gel capsule), and Pentasa.

Generic similar medications are Colazal (balsalazide disodium), sulfasalazine, and Olsalazine (Dipentum). These medications are more complex molecules that gut bacteria cut into mesalamine and leave a byproduct. Similar but different delivery mechanism.

The medication is the same, but the chemical coating might be different (the exact chemical coating is proprietary to each brand). And it might be that coating that's bothering you. The generics don't have a coating.

Ohhh, how I hate it for you! Like you, my insurance denied my Remicade a few weeks ago. Fortunately, my doctor did get approval for another year. It just seems SO...wrong...that our insurance companies have to ability to change what works for us; I'm sure the doctors are frustrated as well. Hopefully, your doc. will get approval.

iPoop said...
Sunshyn, Colazal (balsalazide disodium) is a capsule that can be opened and sprinkled on yogurt or applesauce. Sulfasalazine is a pill that can be crushed. Neither have delayed-release coatings.

Are you sure that the oral mesalamine treatment is enough any more? Have you tried adding an enema or suppository to up the amount of anti-inflammatory capabilities of these medications. Oral and rectal routes combined often produces the best results.

Have you had a stool test to check for infectious causes to your symptoms? Just to make sure there's no c diff also involved.

Thanks for the info on the generics.

I see no reason to go through yet another dr appointment when this ALL started RIGHT AFTER I was forced to change from Asacol due to insurance manipulations - 5 days for the Lialda bad reaction. Then I spend a few weeks back on my remaining Asacol where I was entirely back to (my) normal again, no not perfect but as close as I've ever come. Then I started the Apriso and realized after 20 days that the slow ramp up of discomfort and symptoms I've been experiencing was definitely the old preliminary signs of intestinal inflammation and not my chronic, unrelated, abdominal pain issues.

I'd been better than I had been in ages for a few YEARS now thanks to my remedies (healing clay and aloe). Oh, and ASACOL.

I have ~7 year old Canasa suppositories (yes, its been awhile) I just started those again, but my *&%^* doctor's office is going through some big office upgrade and has been taking a week to get back to me with a nurse who can prescribe anything every time during this huge insurance BS. She, of course, needs to then consult with my dr. Then I generally have to wait on my insurance mail order process, though I think we can pick a new Canasa up from a local pharmacy at least if they ever get around to subscribing it.

Sorry to be so adamant about another doctor appointment being last resort. I'm disabled and any dr appt outside of the house screws me up badly for a couple weeks as well as interfering with my physical therapy. Even worse right now is that my husband has been laid-off for a few weeks, and just the appointment deductible would be too prohibitive.

My doc only has hours in my town 1, maybe 2, days a month. We seem to have to deal with the main office to even reach the nurse. Neither were even in yesterday, and I've pretty much given up waiting on promised callbacks since this all started.The Canasa should be a quick phone call and a trip to the pharmacy if I could just reach the actual nurse. However, the time to get in one of the long term meds that I need to have ordered through the ins. mailorder company then test it. I'm so scared nothing will work, and they'll want to put me one one of the heavier meds.
There had already been quite a delay due to the doctor trying to get me an exception for the Asacol. I requested they try it again, but I don't hold up much hope that I'll get it. I've had ins. companies refuse medical necessity exceptions too often.

I think the nurse has to consult with the doctor because I seem to be quickly becoming a tough case, what with my odd Lialda reaction and the fact that their 2nd go-to doesn't seem to be working. I'm the type that always seems to get strange medication reactions. :grumble:

I finally got an exception for a year's worth of Asacol. The huge delay seemed to be the insurance needing to call it a "pre-authorization" and the doctor's office calling it something else. After we got the correct terminology, it went through right way.

This is a VERY good thing because I'm having trouble tolerating the Sulfasalazine.