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For those in the U.S., does your insurance cover Xifaxan/Rifaximin?

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Posted 11/15/2012 6:42 PM (GMT 0)
When I first started taking Xifaxan in 2004 or 2005 my insurance at the time (Aetna I believe) had no problem paying for whatever quantity my GI prescribed. In the last few years I've had two insurers refuse to pay for more than 10 tablets at a time because it's only FDA approved for treating travelers diarrhea, not UC or any other IBD.

This is a shame because Xifaxan has helped control my UC more than any other drug. I found out about a year ago that I could order an Indian made generic from alldaychemist.com so that's what I've been doing, but I was wondering if any had gotten their health insurance to pay for it recently.

Thanks in advance.
Posted 11/15/2012 9:55 PM (GMT 0)
Hey Richard, what dosage and how often do you take xifaxan, and do you take it in bursts or chronically, as maintenance therapy? I have had three GI's here dismiss my request to try it for UC- they all say that the studies supporting it are tiny, and weak, most likely from another cndition misdiagnosed as UC. But you report results so I am curious re. Your experience. It's non systemic so sounds very safe IMO. My GP said it's very expensive withoutinsurance, but I looked at online Canadian pharmacies and from there it looks fairly cheap, around 1/10th or less of whatmmy GP quoted me as an estimated cost.
Posted 11/15/2012 11:59 PM (GMT 0)

Probiotic said...
Hey Richard, what dosage and how often do you take xifaxan, and do you take it in bursts or chronically, as maintenance therapy? I have had three GI's here dismiss my request to try it for UC- they all say that the studies supporting it are tiny, and weak, most likely from another cndition misdiagnosed as UC. But you report results so I am curious re. Your experience. It's non systemic so sounds very safe IMO. My GP said it's very expensive withoutinsurance, but I looked at online Canadian pharmacies and from there it looks fairly cheap, around 1/10th or less of whatmmy GP quoted me as an estimated cost.

Find a new doctor. The mechanism of action in mitigating UC symptoms has been known for a while:

http://www.ncbi.nlm.nih.gov/pubmed/20627999

Here's another article that elaborates on the role of the pregnane x receptor activation on reducing inflammation:

http://www.ncbi.nlm.nih.gov/pubmed/22609277

I take it as a maintenance drug - 1 200mg tab twice a day. I go up to 3 or 4 if I'm flaring. It plus chlorogenic acid has taken me from a bad flare to remission:

https://www.healingwell.com/community/default.aspx?f=38&m=2559569&p=2

The Canadian pharmacies are just reselling the Indian generics. It's probably even cheaper and fresher from an Indian pharmacy like alldaychemist.com. And the brand name drug is very expensive in the US - about $13 per tablet I think. It's 30 cents per tab for the generic from alldaychemist.

Rifaximin has been a God send for me, and the safety profile is excellent because it's non-systemic. I was the one who told my GI about it and showed him the early studies (yeah, I'm that kind of patient). He now rx's it for lots of his patients. I'd encourage you to try it if you can.

Post Edited (Richard in NY) : 11/15/2012 5:13:17 PM (GMT-7)

Posted 11/16/2012 12:31 AM (GMT 0)
Xifaxin was covered in 2008 or '09 by my insurer when my GI decided to try me on it for a month or so, I can't remember how long I took it. I had no difference in symptoms (continued very bad) so did not continue it. I have high deductible coverage but was also taking expensive Asacol at the time and met deductible easily that year.
Posted 11/16/2012 8:14 AM (GMT 0)
It paid when my gastro Rxed Xifaxan for 10 days with 1 refill. Even though it's not a systemic antibiotic, some members here have speculated that it contributed to their subsequent C-diff. So staying on it indefinitely may not be a good idea. / Old Hat (32 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 11/16/2012 1:23 PM (GMT 0)
@Old Hat- did you try it? I agree that if it is hazardous long term, that puts a damper on its vianility for maintenance. However, it seems GI's dismiss it because they think ofit as a weapon only against SIBO- yet as the link Richard posted shows, it may indeed have another mechanism of action for IBD. @Richard- how long dis it take to notice a benefit? I have a three day suplly which my GP rx'd for me as a traveller's diarrhea emergency supply for purposesof trying... But I am assuming it may have taken many weeks to notice any benefit? I have seen most posts on this drug in this forum report no benefit.
Posted 11/16/2012 1:31 PM (GMT 0)

Old Hat said...
It paid when my gastro Rxed Xifaxan for 10 days with 1 refill. Even though it's not a systemic antibiotic, some members here have speculated that it contributed to their subsequent C-diff. So staying on it indefinitely may not be a good idea. / Old Hat (32 yrs with left-sided UC; presently in remission taking brandname Colazal)

I'm aware of the increased risk of c-diff and for the first year or two I was on it my GI tested for it periodically. It hasn't been an issue in the 8 years or so I've been on the med, so I don't seem to be prone to it.

All meds and medical interventions have risks. So does not taking them.
Posted 11/17/2012 1:20 AM (GMT 0)
Alldaychemist.com no longer lists a generic rifaximin on their website. They used to sell a product called Torfix that worked well for me. I've sent an email to their customer service dept. to find out it it's temporary or permanently gone. It's a shame because it's not that easy to find, particularly at the low prices ADC used to sell it for.
Posted 11/17/2012 3:05 AM (GMT 0)
Medsmex sells it but much more expensive- over a dollar for a 200 mg pill. Still, a fraction of the $13/pill of the US prices.
Posted 11/17/2012 6:42 AM (GMT 0)
Probiotic-- no, I ended up not taking it. The package insert warns that it can increase bleeding in some patients. That definitely scared me. I was able to get out of the flare with brandname Colazal & a longterm "staple" diet, something Old Mike recently posted about. But when my gastro Rxed the 10-day Xifaxan, I did ask about its benefit here on the forum, and I remember that Rey replied that it helped her daughter to subdue one flare in combo with the 5-ASA she already had been taking. Otherwise, I don't recall anyone posting about longterm use/flare relief from it prior to this thread. / Old Hat (32 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 11/17/2012 3:26 PM (GMT 0)

Probiotic said...
Medsmex sells it but much more expensive- over a dollar for a 200 mg pill. Still, a fraction of the $13/pill of the US prices.

Thanks for the tip. I think I'm going to get it here if it's really unavailable on ADC:

https://www.progressiverx.com/store/product.php?productid=18166

I can get 400mg tablets for less than the 200mg tablets on medsmex, and progressiverx has good reviews on pharmacyreviewer.com. I'll have to get my GI to write me a script, but that won't be a problem.

Post Edited (Richard in NY) : 11/17/2012 9:13:09 AM (GMT-7)

Posted 11/17/2012 7:00 PM (GMT 0)
Hmm do you know for sure if they require an rx? It seems a fight for me to get one right now. Hopefully if I emphasize how it's my last ditch before surgery, someone will relent.
Posted 11/17/2012 7:03 PM (GMT 0)
Progressiverx says on their website that they won't fill the order without an rx, and there's no reason to doubt them. Medsmex does not seen to require the script, so if you can't get one that might be your best bet.

I think you need to find a new GI. Sheesh.
Posted 11/17/2012 8:03 PM (GMT 0)
Yeah trying to get a new GI. My GP is very progressive and if I tell him I struck out with multiple GI's he'll probably come through. Am gonna order some medsmex to cover my bases in case I am left whistling in the wind.
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