VSL#3DS rejected by insurance

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aguywithuc
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Date Joined Jun 2010
Total Posts : 2507
   Posted 1/17/2011 8:50 PM (GMT -6)   
I suspect there are really no alternatives here. IOW if you scale it down from DS to regular the price scales with it unsurprisingly. I am told it is $360.00 full price.

The insurance company told me before I signed up that non-formulary brands would be 40% covered leaving me with 60%. The card says that too. Nobody told me there is another category non-formulary-REJECTED.

1st insurance company to pull this on me. They said they simply do not cover medical-food.

I guess I will stock up and go slowly ramping quickly up to 4 per day if I think I am in trouble. I can buy my kid a lot of clothing each month for that price.

notsosicklygirl
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Date Joined Dec 2008
Total Posts : 10379
   Posted 1/17/2011 8:55 PM (GMT -6)   
Are you in the US? I asked my pharmacy about presscription probiotics and they told me there weren't any.
Co-moderator: Ulcerative Colitis
03/07: Diagnosis: Mild Proctitis | 08/08: Diagnosis: Pancolitis - FLARE & Anemic! Asacol (3600mg) + Canasa (1000mg morning/night) | 01/10: FLARE! Prednisone + Cortifoam + Asacol + Canasa + Rowasa | Currently: stable - Asacol (3200mg) + Canasa (nightly) + 6mp + Allopurinol + Prednisone + Ponstel + Klonopin + Ambien

Cadillac Lover
Regular Member


Date Joined Feb 2009
Total Posts : 235
   Posted 1/17/2011 10:12 PM (GMT -6)   
I got a script for vsl3DS today and dropped it off at a rite aid. They are going to call me tomorrow to tell me if my insurance company covers it.
Age 30. Diagnosed with UC summer of 08.
Diagnosed with severe UC 1-3-11 from 2nd cscope.
Pred (50mg tapering 10mg every 10 days).
AsacolHD (2 @3 x a day)
Hydrocortisone Supp. (Nightly or every other night)
Probiotics, Omegas, Vitamins, Metamucil.

aguywithuc
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Date Joined Jun 2010
Total Posts : 2507
   Posted 1/17/2011 11:15 PM (GMT -6)   
notsosicklygirl said...
Are you in the US? I asked my pharmacy about presscription probiotics and they told me there weren't any.


Yes, I have had a prescription for VSL#3DS for years.

songlady
Veteran Member


Date Joined Aug 2009
Total Posts : 3252
   Posted 1/18/2011 10:23 AM (GMT -6)   
I have a prescription for VSL#3DS and get it through the Medco mail-order pharmacy (I'm in the US.) It's "covered" but my copay is still $150 for the three months. But... my prescription is for 2 DS packets a day, so..... I get a huge shipment of the stuff, I shouldn't complain.
Co-Moderator, UC Forum
Age 54. Diagnosed UP 1983, UC 1986
Asacol - 16 pills/day,
alternating steroid/Rowasa enemas, Canasa occasionally
Metamucil - 2 doses/day
VSL#3DS 3 x daily, Multivitamin, Calcium and D
homemade yogurt each day
trying Slippery Elm again
starting to flare......
Son, 17, dx pancolitis 2007, in remission

UCPop
Regular Member


Date Joined Oct 2009
Total Posts : 58
   Posted 1/18/2011 10:50 AM (GMT -6)   
We have been turned down with the medical food excuse and this was after VSL#3DS was actually covered for a year - we are still fighting the decision.

Here is a very inexpensive alternative that I think many folks can benefit from - it has been discussed on here before, but maybe this will help someone.

VSL#3 Yogurt
I buy organic milk, which has a very long expiration date (I assume this is from a very thorough pasteurization process) and pour a half gallon into a Yogourmet yogurt maker. I then sprinkle just a very little bit of a VSL#3DS package on the top and stir it in. I allow to ferment for 2 full days stirring it up once or twice during the fermentation process. If I want the yogurt to be drinkable (thinner) I use a wand hand mixer to stir it up. I used to boil the milk first, but have found there is no appreciable difference in the yogurt produced so I eliminated this step.

You can make 4 - 8 (or maybe more) half gallons of VSL#3 yogurt with each VSL#3DS packet. The yogurt tastes good and I drink it without adding any honey or fruit. This may be an acquired taste.

This yogurt provides the VSL#3 probiotics in a very easy and inexpensive method. The downside to the process is not having any idea what the probiotic dosage in cfu (colonizing forming units) is. You also do not know that you have the same ratio as a VSL#3DS packet, because the 9 different probiotic strains may reproduce at different rates.

I think you could counter the downside of this method by consuming large quantities of the yogurt. My feeling with probiotics, is that you cannot get too much of the strains in VSL#3. By overloading the system you are preventing the bad bacteria from growing and creating an inbalance.

My daughter still takes her VSL#3DS with applesauce and psyllium seed powder and does not like the taste of the VSL#3 yogurt. However, if the cost is an issue I believe this yogurt will help.

Best of luck to all,
UCPop
Daughter has UC - Diagnosed Nov '08 - lots of ups and downs - always looking for information and support
Current Meds:
Lialda, VSL#3DS (once per day), Florastor, Fish Oil, Iron Supp, Zinc Supp, Calcium Supp, Multi-vit, B Vit, D Vit, Curamin (turmeric + boswellia), Oregano Oil, Psyllium Seed Powder (twice per day)
Past Medications:
Colazal - worked fairly well initially
Asacol - passed many pills whole
Rowasa Enemas - worked well to help end flare - tapered off slowly

aguywithuc
Veteran Member


Date Joined Jun 2010
Total Posts : 2507
   Posted 1/18/2011 2:37 PM (GMT -6)   
UCPop said...
We have been turned down with the medical food excuse and this was after VSL#3DS was actually covered for a year - we are still fighting the decision.

Here is a very inexpensive alternative that I think many folks can benefit from - it has been discussed on here before, but maybe this will help someone.

VSL#3 Yogurt



That sounds worthwhile. What brand of natural yogurt ? Have ever stopped for a month to see if there is a significant difference ?

UCPop
Regular Member


Date Joined Oct 2009
Total Posts : 58
   Posted 1/18/2011 4:00 PM (GMT -6)   
aguywithuc,

I use Kirkland Organic milk from Costco and make my own yogurt using the VSL#3 as a starter. Just pour the milk into the yogurt maker (I use an inexpensive Yogourmet Brand), sprinkle in some VSL#3 powder and let it ferment for 2 full days. I have found that is makes good tasting yogurt and I can control how thick it is by whether I use an electric wand blender to stir it up during the fermentation. The fermentation process creates some excess gas pressure in the container (I assume this is the same thing occurring when yogurt gives us gas during colonization of the colon), so I release this and stir up the mixture at least once during the 2 day fermentation. I then pour the yogurt into tupperware containers and refrigerate them until I drink it.

The VSL#3 powder is an excellent yogurt starter. You do not need a brand of natural yogurt - just add the VSL#3 to the milk. I use just a little sprinkle and can make 4 - 8 batches with one VSL#3DS pouch. I have experimented using a full VSL#3DS pouch, a half pouch and just a sprinkle. The fermentation cycle still lasts just about two days before it appears that fermentation is complete. As the probiotic bacteria continues to double it appears that all of the lactose is fermented by the end of the 2 day period.

UCPop
Daughter has UC - Diagnosed Nov '08 - lots of ups and downs - always looking for information and support
Current Meds:
Lialda, VSL#3DS (once per day), Florastor, Fish Oil, Iron Supp, Zinc Supp, Calcium Supp, Multi-vit, B Vit, D Vit, Curamin (turmeric + boswellia), Oregano Oil, Psyllium Seed Powder (twice per day)
Past Medications:
Colazal - worked fairly well initially
Asacol - passed many pills whole
Rowasa Enemas - worked well to help end flare - tapered off slowly

aguywithuc
Veteran Member


Date Joined Jun 2010
Total Posts : 2507
   Posted 1/18/2011 9:03 PM (GMT -6)   
UCPop said...
aguywithuc,

I use Kirkland Organic milk from Costco and make my own yogurt using the VSL#3 as a starter. Just pour the milk into the yogurt maker (I use an inexpensive Yogourmet Brand), sprinkle in some VSL#3 powder and let it ferment for 2 full days. I have found that is makes good tasting yogurt and I can control how thick it is by whether I use an electric wand blender to stir it up during the fermentation. The fermentation process creates some excess gas pressure in the container (I assume this is the same thing occurring when yogurt gives us gas during colonization of the colon), so I release this and stir up the mixture at least once during the 2 day fermentation. I then pour the yogurt into tupperware containers and refrigerate them until I drink it.

The VSL#3 powder is an excellent yogurt starter. You do not need a brand of natural yogurt - just add the VSL#3 to the milk. I use just a little sprinkle and can make 4 - 8 batches with one VSL#3DS pouch. I have experimented using a full VSL#3DS pouch, a half pouch and just a sprinkle. The fermentation cycle still lasts just about two days before it appears that fermentation is complete. As the probiotic bacteria continues to double it appears that all of the lactose is fermented by the end of the 2 day period.

UCPop


So this not only amplifies the amount of VSL#3DS bacteria, it eliminates all lactic acid ? This is pretty cool. Do you have any tips for flavoring it ? Also the yogurt maker just sits on your counter and keeps it warmed up ? No special handling ? Yogurt is just spoiled milk ?

Thanks!

UCPop
Regular Member


Date Joined Oct 2009
Total Posts : 58
   Posted 1/19/2011 12:21 AM (GMT -6)   
aguywithuc,

I guess no special handling is the right term. Yes, yogurt is indeed "spoiled" or fermented milk. I think the key is to get the correct strains of bacteria growing to make the yogurt. Some folks say to boil the milk for a few minutes to make sure all of the residual bacteria in the milk is killed and also to break down some of the enzymes. I used to boil the milk, but have stopped doing this to save time and effort and I have not noticed any degradation. I try to keep the yogurt maker (especially the actual container) as clean as possible, to prevent any off taste or smell. You can flavor the yogurt with honey, fruit, vanilla or whatever sounds good. It does go well in smoothies. I usually just drink it plain. It tastes a little like buttermilk to me, which I enjoy.

I do not know if all of the lactose is gone, but I believe this is what the probioitic bacteria "digests" so they can reproduce. The colonies of bacteria grow exponentially 1-2-4-16-32-64-128-256-512-1024-2048-4096-etc, so yes you are multiplying the original number of probiotic cfu (colony forming units) very quickly. So the 1/8 of a packet used as a starter becomes twice as many cfu as the original packet in just 4 steps in the process (from 1 to 16).

As I said, I am not sure if all of the 9 types of probiotic bacteria in VSL#3 double at the same rate, so you may wind up with a different ratio of bacteria. However, I think you can easily get past this downside by consuming very large amounts of the probiotics very inexpensively.

Like I said, I hope this helps and I welcome other thoughts on this subject. I have a background in science and math, but what I know about UC, UC treatments and yogurt comes from research on this forum and from professional articles I can find access to. I also began making yogurt using the SCD recipe, using good starter yogurt. It took a while before I began to experiment with VSL#3 as a starter. I have been very happy with the quality and taste of the VSL#3 yogurt. I eat it for general health. I cannot convince my daughter that it tastes good, so she still prefers the VSL#3DS with applesauce and psyllium seed powder.

Best of luck to all,
UCPop
Daughter has UC - Diagnosed Nov '08 - lots of ups and downs - always looking for information and support
Current Meds:
Lialda, VSL#3DS (once per day), Florastor, Fish Oil, Iron Supp, Zinc Supp, Calcium Supp, Multi-vit, B Vit, D Vit, Curamin (turmeric + boswellia), Oregano Oil, Psyllium Seed Powder (twice per day)
Past Medications:
Colazal - worked fairly well initially
Asacol - passed many pills whole
Rowasa Enemas - worked well to help end flare - tapered off slowly

Post Edited (UCPop) : 1/18/2011 10:24:56 PM (GMT-7)


aguywithuc
Veteran Member


Date Joined Jun 2010
Total Posts : 2507
   Posted 1/19/2011 10:02 AM (GMT -6)   
That is awesome!

Thanks you

Cadillac Lover
Regular Member


Date Joined Feb 2009
Total Posts : 235
   Posted 1/19/2011 11:44 AM (GMT -6)   
Pharmacy called last night saying blue shield does not cover probiotics. I figured that but was just giving it a shot. The price they told me is about $120 for a month supply of vsl3DS. Cant afford it :(
Age 30. Diagnosed with UC summer of 08.
Diagnosed with pancolitis 1-3-11 from 2nd cscope.
Pred (40mg tapering 10mg every 10 days).
AsacolHD (2 @3 x a day)
Probiotics, Omegas, Vitamins, Metamucil.

Noah_Bodie
Regular Member


Date Joined Nov 2010
Total Posts : 164
   Posted 1/19/2011 2:51 PM (GMT -6)   
Check into the prices of VSL 3 through pharmacychecker.com
http://www.pharmacychecker.com/Pricing.asp?DrugId=71921&DrugStrengthId=133342&sortby=CPP

Also, read this on buying from Canada.
Ken
Age 43
1200 mg Canadian Asacol twice a day
20 mg Omeprazole once a day

Post Edited (Noah_Bodie) : 1/19/2011 3:49:33 PM (GMT-7)


Peety
Veteran Member


Date Joined Mar 2008
Total Posts : 2838
   Posted 1/19/2011 5:40 PM (GMT -6)   
You might also check the ingredients in the VSL and see if there are other probiotics available non-Rx that have almost the same thing (and/or work as well).

I find some pretty strong ones at the health food grocery store (refrigerated).
49 year old female attorney, diagnosed UC/pancolitis 1985.
Asacol for 20+ years with Prednisone & Rowasa for flares (But nothing since Remicade).
Food sensitivity test by Naturopath showed wheat/gluten, other intolerances, helped some.
Remicade started April 2009 (Humira denied) and doing great~ learning what normal is~ wow

baconeggsyum
Regular Member


Date Joined May 2010
Total Posts : 303
   Posted 1/19/2011 5:48 PM (GMT -6)   
VSL shouldn't be covered because it is not and never will be a "drug". Having said that, it should be covered because the darn stuff works. What a dumb system.
Update : Quit Imuran, off Prednisone and now doing FANTASTIC!!
Getting new GI referral on Nov 10th!!
Ultimate Protec Multi Probiotic 12 Billiono Active - 1 pill at nigth
Boswellia 3x a day
Tumeric 3x day
Centrum Forte 1x
Pantothenic Acid 100mg a day
Metamucil AM and PM
6 x 800 asacol
4000 Vitamin D

aguywithuc
Veteran Member


Date Joined Jun 2010
Total Posts : 2507
   Posted 1/19/2011 7:49 PM (GMT -6)   
baconeggsyum said...
VSL shouldn't be covered because it is not and never will be a "drug". Having said that, it should be covered because the darn stuff works. What a dumb system.


The problem is the meds are one outfit and the medical is another. So the drug company saves money but costs the medical insurer money because of more trips to the hospital for those not using VSL#3.

susans53
Regular Member


Date Joined Jun 2010
Total Posts : 218
   Posted 1/19/2011 7:55 PM (GMT -6)   
I have Empire Blue Cross/ Shield and they cover VSL#3D. I get it at Target.
UC 1996
5 asa, predisone, 6 mp
X-mas present- Dec 26, 2000, Emergency j-pouch surgery
Multiple complications, J-pouch redo- July 3,  2001.
Take down-Jan 3,  2002
Chronic pouchitis: cipro, pentassa, xifican, cortioam, canassa, leviguin, lexapro, vit D, fish oil, probiotics, lot's of other vit's
Gall bladder out-Oct 1997
Latest flare April 27 2010 Hosptial for 1 week-remciade
Possible CD, Possible pouch removal-anxiety-can you blame me?
Adhesions

Jokerlola
Regular Member


Date Joined May 2010
Total Posts : 60
   Posted 1/20/2011 1:16 AM (GMT -6)   
For those who's insurance won't pay for VSL#3 or just can't afford it. See if you can get free samples from your doctor or bite the bullet and buy just one box of regular VSL#3. You can then make yogurt out of it as is posted above. You can easily make yogurt even without a yogurt maker. If you use regular milk, heat up a quart to to 180 degrees to re-pasteurize it then let it cool to 115 to 110 degrees. If you are using ultra-pasteurized milk you just need to heat it up to 115 to 110. Now sprinkle about half a regular packet of VSL#3 and stir it in good. Transfer it to a glass jar. You can then incubate it in the oven with either just the pilot light on or if electric, the light bulb on or you can wrap it up in a towel and put it in a warmed up cooler. Just so you can keep it at 100 degrees during the incubation. Then put it in the fridge after 12 to 48 hours depending on how strong you want the yogurt.

Now here is where you can save money and still have your VSL#3; As you consume the yogurt, save about 2 or 3 tablespoons of the yogurt and use it to make your next batch of yogurt. Now if you always save 2 or 3 tablespoons of the yogurt, you will have and endless supply of VSL#3 yogurt for only the cost of milk!
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