Asacol HD - Might need to Switch - Help please!

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

UC89
Regular Member


Date Joined Feb 2014
Total Posts : 74
   Posted 11/6/2017 6:24 PM (GMT -7)   
Hi Everyone - Long story short, my job is changing insurance providers on me, and now I will be needing to change prescription coverage providers as well. I looked and have called - they do not cover Asacol HD (or rather the generic Mesalamine 800 DR) which I do currently take the generic after being on the brand for 3 years. So I have a multipart question and am hoping any of you can help:

1. Have you successfully gotten a prior authorization for medication not covered? If so, was it a battle? Did they make you do steps to prove you tried other medications? I am nervous about 'rocking the boat' so to speak.

2. Anyone switched from Asacol HD to anything else that works? The formulary options they suggest that they will cover are: Sulfazine TAB 500MG, sulfasalazine TAB 500MG, sulfasalazine TAB 500MG DR, balsalazide disodium CAP 750MG, Azulfidine TAB 500MG, Azulfidine EN-Tabs TAB 500MG EN, Lialda TAB 1.2GM, Pentasa CAP 500MG CR.

The first four listed (Sulfazine and the Sulfasalazines and Balsalazide would be the most cost effective as well. They would save me close to $3000 annually with my new insurance if they would work).

Anyone have any input they can provide on any of this? I am really concerned and trying to prepare myself before my next GI visit in a few weeks so I can have an educated conversation with my doctor about what route to take.

Thanks so much!

Post Edited (UC89) : 11/6/2017 6:27:23 PM (GMT-7)


iPoop
Forum Moderator


Date Joined Aug 2012
Total Posts : 10854
   Posted 11/6/2017 7:11 PM (GMT -7)   
Sometimes switching between mesalamines is uneventful and other times it causes issues. No knowing which is you in advance. Most doctors or pharmacists will say there's little difference among the various formulations. Anecdotally here, some have said one works better for them than another.

You can try an appeal, sometimes they work and other times not. Worth a try.

Same goes on savinv money, I'd give it a try. I'd choose Balsalazide over sulfasalazine as it is less prone to side effects. Sufasalazine does help with joint aches if you have any (it's an Rheumatoid arthritis drug and uc drug).
Moderator Ulcerative Colitis
John
, 39, UC Proctosigmoiditis
Rx: Remicade @5mgs/kg/6wks; daily 75mgs 6MP, 4.8g generic-Lialda, and rowasa

Urgency Roused "Oh the places I've pooed from culverts to shady bathrooms" the memoirs of a UC patient. Run, don't walk, to you local bookstore...

DBwithUC
Veteran Member


Date Joined Feb 2011
Total Posts : 3923
   Posted 11/6/2017 7:27 PM (GMT -7)   
appeals vary company to company

i would try lialda. i do well on it, and there a copay assist card
11/08: ischemic colitis and scope perf colon. 12cm colon/ileocecal resected. IV antib:sepsis.
01/10: Dx: Mod. UC pancolitis. Rx: Lialda 3x.
02/11: Major flare w/antib:sinus. Rx: 40mg Pred taper. 6mp.
07/11: Histol remiss rt/trans; worse sigmoid. Rx: Rowasa & hydrocort
---
Curr: 1-2 soft-formed stool, no urgency: Lialda 2x, NO PRED, probiotics, Vit-D/C

UC89
Regular Member


Date Joined Feb 2014
Total Posts : 74
   Posted 11/6/2017 9:12 PM (GMT -7)   
DBwithUC said...
appeals vary company to company

i would try lialda. i do well on it, and there a copay assist card


Thanks for your feedback! I looked - they seem to have discontinued the copay assist last month...honestly the lialda would cost me as much as the Asacol HD would but would be approved easier by my insurance. It would still end up costing me about $3,000 a year extra. I'll definitely talk to my doctor about it though if my insurance gives me a runaround on my medication. thanks!

UC89
Regular Member


Date Joined Feb 2014
Total Posts : 74
   Posted 11/6/2017 9:22 PM (GMT -7)   
iPoop said...
Sometimes switching between mesalamines is uneventful and other times it causes issues. No knowing which is you in advance. Most doctors or pharmacists will say there's little difference among the various formulations. Anecdotally here, some have said one works better for them than another.

You can try an appeal, sometimes they work and other times not. Worth a try.

Same goes on savinv money, I'd give it a try. I'd choose Balsalazide over sulfasalazine as it is less prone to side effects. Sufasalazine does help with joint aches if you have any (it's an Rheumatoid arthritis drug and uc drug).


thanks for your feed back! I will research balsalazide some more. I have never even heard of it before this week.

iPoop
Forum Moderator


Date Joined Aug 2012
Total Posts : 10854
   Posted 11/7/2017 6:25 AM (GMT -7)   
All of the medications you mention deliver anti-inflammatory mesalamine to the large intestine but how it's delivered varies.

Generic Balsalazide Disodium (brand name Colazal) and generic Sulfasalazine (brand name Azulfidine) are an older class of UC medications, therefore are true generics at a reasonable cost. Unlike Lialda/Asacol hd, there is no red/orange chemical coating with PH-delayed-release delivery. Rather, they are more complex molecules that gut bacterium breaks down into mesalamine and a byproduct. It's the same result but achieved through different means. In the case of sulfasalazine, that unused byproduct is sulfa which is an allergen to some and can cause headaches and number of other side effects, but it is the cheapest by far of all UC meds (about $75 a month if you pay entirely out of pocket). The majority don't experience side effects of sulfasalazine, you cold always try it and if you get headaches then switch. Overall Balsalazide is a safer bet as the byproduct does not appear to have the same adverse reactions, it's a little more expensive ($200-400 a month if paid entirely out of pocket). Both are tablets taken multiple times a day. There's a lot more interest in these lately due to prescription med pricing. A number of posters use Balsalazide, and some use sulfasalazine.

Balsalazide Disodium is generic of Colazal, comes in 750mg pills, a typical dose is 6,750mgs or 9 pills daily.

Sulfasalazine is a generic, comes in 500mg pills, a typical dose is 4,000mgs or 8 pills daily.

Lialda is similar to asacol hd, but larger pills: 1,200mg instead of 800mgs. Lialda is taken all at once in the morning, which is it's biggest difference. Lialda has a generic that's new to market but at $1,200 a month it's a rather expensive generic.
Moderator Ulcerative Colitis
John
, 39, UC Proctosigmoiditis
Rx: Remicade @5mgs/kg/6wks; daily 75mgs 6MP, 4.8g generic-Lialda, and rowasa

Urgency Roused "Oh the places I've pooed from culverts to shady bathrooms" the memoirs of a UC patient. Run, don't walk, to you local bookstore...

Post Edited (iPoop) : 11/7/2017 6:29:21 AM (GMT-7)


CCinPA
Veteran Member


Date Joined Dec 2014
Total Posts : 939
   Posted 11/7/2017 11:11 AM (GMT -7)   
I had success getting Asacol approved through Express scripts even though it wasn't on the formulary, but I had tried several other mesalamines and they made me worse so I'm sure that helped to get the approval.
58 yo female diagnosed w/UC to mid transverse 1/1/13, now UC or Crohn's colitis. Remission since 10/16, confirmed by scope in Dec 16. Current meds: Entyvio 7/22/16, Asacol HD 2 Tabs 3x/day, Capozide 1/day (hypertension). omeprazole. OTC: Loratadine 1/day, multivitamin 1/day.

UC89
Regular Member


Date Joined Feb 2014
Total Posts : 74
   Posted 11/7/2017 9:24 PM (GMT -7)   
iPoop said...
All of the medications you mention deliver anti-inflammatory mesalamine to the large intestine but how it's delivered varies.

Generic Balsalazide Disodium (brand name Colazal) and generic Sulfasalazine (brand name Azulfidine) are an older class of UC medications, therefore are true generics at a reasonable cost. Unlike Lialda/Asacol hd, there is no red/orange chemical coating with PH-delayed-release delivery. Rather, they are more complex molecules that gut bacterium breaks down into mesalamine and a byproduct. It's the same result but achieved through different means. In the case of sulfasalazine, that unused byproduct is sulfa which is an allergen to some and can cause headaches and number of other side effects, but it is the cheapest by far of all UC meds (about $75 a month if you pay entirely out of pocket). The majority don't experience side effects of sulfasalazine, you cold always try it and if you get headaches then switch. Overall Balsalazide is a safer bet as the byproduct does not appear to have the same adverse reactions, it's a little more expensive ($200-400 a month if paid entirely out of pocket). Both are tablets taken multiple times a day. There's a lot more interest in these lately due to prescription med pricing. A number of posters use Balsalazide, and some use sulfasalazine.

Balsalazide Disodium is generic of Colazal, comes in 750mg pills, a typical dose is 6,750mgs or 9 pills daily.

Sulfasalazine is a generic, comes in 500mg pills, a typical dose is 4,000mgs or 8 pills daily.

Lialda is similar to asacol hd, but larger pills: 1,200mg instead of 800mgs. Lialda is taken all at once in the morning, which is it's biggest difference. Lialda has a generic that's new to market but at $1,200 a month it's a rather expensive generic.


thank you for this very thorough breakdown. this helps me a lot, I feel when I see my doctor I will know more of what to talk about now, so thank you!!!!!!! hopefully one of these will work for me. if not I'm afraid the asacol hd generic I take now won't work anymore if I go back on it. I hate that a company can try and tell me whats best for my UC based on their costs. I already spend 2k a year getting medication so its scary I might have to spend another 2k next year and forever. hopefully a cheaper option will work. thanks again!!

UC89
Regular Member


Date Joined Feb 2014
Total Posts : 74
   Posted 11/7/2017 9:45 PM (GMT -7)   
CCinPA said...
I had success getting Asacol approved through Express scripts even though it wasn't on the formulary, but I had tried several other mesalamines and they made me worse so I'm sure that helped to get the approval.
thank you for your response - I hope I don't have to find out the hard way stuff won't work for me sad

Casey_LB
Regular Member


Date Joined Mar 2015
Total Posts : 182
   Posted 11/8/2017 12:14 AM (GMT -7)   
I switched from Asacol HD to balsalaside without any obvious effect. But I am also taking Entyvio, 6-MP, hydrocortisone so it's not clear how much good mesalamine was doing.

UCinGV
Regular Member


Date Joined Mar 2007
Total Posts : 388
   Posted 11/8/2017 2:01 PM (GMT -7)   
My insurer also stopped covering Asacol HD, and so I got pushed into Lialda. I have felt much better since around that time but I can't say for certian it is because of the Lialda.

I have recently switched to generic Lialda (Zydus Mesalamine DR) and I have noticed no negative effects.
2 Lialda daily
100 mg Imuran
Generic Centrum multivitamin
Sometimes a fish oil pill
Align probiotic
2000IU Vitamin D

UC89
Regular Member


Date Joined Feb 2014
Total Posts : 74
   Posted 11/11/2017 7:56 AM (GMT -7)   
UCinGV said...
My insurer also stopped covering Asacol HD, and so I got pushed into Lialda. I have felt much better since around that time but I can't say for certian it is because of the Lialda.

I have recently switched to generic Lialda (Zydus Mesalamine DR) and I have noticed no negative effects.


I'm so confused about the generic lialda. I take the generic asacol hd right now and it's also called melamine dr and by zydus. but it sounds like there is another one? my new plan won't even cover that generic I am on by zydus - and I cannot find the lialda generic. lialda sounds like it could be a good option for me to switch to, but cost wise it'll be a lot more expensive than if I can take the others. however I guess at this point I just want to be healthy so I'd rather spend an extra 3k a year I guess. I feel like it should be illegal for insurance companies to do this if they know something works for someone

iPoop
Forum Moderator


Date Joined Aug 2012
Total Posts : 10854
   Posted 11/11/2017 9:03 AM (GMT -7)   
Zydus makes the licensed-generic of asacol hd. It's blessed/approved by the asacol hd patent holders. My insurance cobsidered this to be brand-named as a consequence thereof.
www.zydususa.com/product-details/?id=216

Zydus makes the generic of lialda, shire fought zydus tooth-and-nail in the courts and lost. So, my insurance calls this a generic. It was on the market after the victory in the courts.
www.zydususa.com/product-details/?id=307

Both are called mesalamine Delayed Release (DR) but the pill size is different 800mgs versus 1,200mgs. The links above may help your pharmacy get them. Most pharmacies do fill lialda prescriptions as the generic and same with asacol hd prescriptions.
Moderator Ulcerative Colitis
John
, 39, UC Proctosigmoiditis
Rx: Remicade @5mgs/kg/6wks; daily 75mgs 6MP, 4.8g generic-Lialda, and rowasa

I believe that my anus is a portal from Hades as only evil comes out of it.
New Topic Post Reply Printable Version
Forum Information
Currently it is Thursday, November 23, 2017 2:45 AM (GMT -7)
There are a total of 2,897,074 posts in 317,969 threads.
View Active Threads


Who's Online
This forum has 157548 registered members. Please welcome our newest member, Vicky Bjennings.
181 Guest(s), 0 Registered Member(s) are currently online.  Details



About Us | Advertise | Donate
Newsletter | Privacy Policy & Disclaimer
Follow HealingWell.com on Facebook Follow HealingWell.com on Twitter Follow HealingWell.com on Pinterest
©1996-2017 HealingWell.com LLC  All Rights Reserved.