I just wanted to write this to consolidate some information scattered around the board and also add some information I've found on my own:

VSL DS - 1 sachet - 900 Billion Bacteria - prescription only - 20 sachets per box
VSL - 1 sachet - 450 Billion Bacteria - over the counter - 30 or 10 sachets per box
VSL Capsules - 1 capsule - 112.5 Billion Bacteria - over the counter - 60 capsules per bottle

The only VSL that is covered under insurance is VSL DS. It comes in boxes of 20, each sachet contains 900 billion bacteria with the commonly prescribed dose being 2 sachets per day. This is the dose that is noted as therapeutic in the studies that have been run and the recommended dose post pouchitis, after antibiotic treatment (1.8 trillion per day).

So, following the guidelines for a daily therapeutic dose post pouchitis you'd need:
2 VSL DS sachets daily - approximate cost for 30 days WITH INSURANCE COVERAGE, $188 (will vary with coverage)
4 VSL sachets daily - approximate cost for 30 days, $296-$394 depending on bulk ordering **
16 VSL capsules daily - approximate cost for 30 days, $376-$416 depending on bulk ordering **
** Pricing based off VSL website.

As you can see it pays to try and get insurance coverage if you want to stick with the established dosing guidelines - and if you're someone that struggles with pouchitis you probably do.

Insurance coverage:
Just because your pharmacy says it isn't covered doesn't necessarily mean that is the case. The customer service reps for your insurance might also give you the wrong information (some of mine did). For example I watched my doctor electronically send an order to my Wallgreens pharmacy for the VSL DS. I went to pick it up and was told it wasn't covered by insurance because it was over the counter. I took a look and it was the regular VSL sachets which are easy to spot because they come in a box of 30. Long story short i got it covered by doing some research and supplying the NDC (National Drug Code) directly to the pharmacist, which her system took and processed.

If you've been denied insurance coverage:
Step 1 - Make sure your doctor is specifically writing the scrip for VSL DS
Step 2 - Speak to your pharmacist and supply them with the below NDC
Step 3 - My next step is exploring the mail order program to see if I can drive the price down more. I will edit this step when this is completed.

VSL DS NDC - 54482093001

I also found 2 other codes in my research and I'm not sure what they're for. I'm including them in case they are of use to anyone, possibly the international community? Not sure but if someone wants to comment on them I can edit this as needed.
GCN (Generic Code Number) is 97109
DIN (Drug Identification Number) is 00903105

I hope this helps out whoever should find it - Good Luck

Todd

thank you for this info - much appreciated!

That is a great posting! Hope all who need VSL#3 read this.

I take it now under insurance. At first, I had to fight them to cover regular VSL#3. After hours on the phone and writing letters, I called and said do you cover VSL#3 DS. They said yes we do. grrr!!!!

Thanks for this post. It's timely for me because I just started VSL 3 this week. I had to wait to get disability before I could afford it. I'm only using 4 capsules a day and haven't seen much in the way of effects on my pouch. I can't see spending such astronomical sums per month even with the disability money. I'm going to try your strategy and see if I can get my insurance to pay. Thank you, thank you, thank you.
Theresa

You all are very welcome. I'm glad some people are finding it useful. I need to edit a couple of things. My costs are actually around 150 per month, and I still need to do the research on the mail order. I'm getting married on Saturday so it'll probably be a little while before I can complete it.

If anyone has questions or wants to add information feel free to post as comments or send them directly to me as a PM and I can edit the original post.

Todd

Bad news. I called CIGNA yesterday and was told that no probiotics are covered because of the plan that my husband's employer opted for. If the school district he works for had chosen another plan probiotics would be covered. The person I spoke to really seemed to want to help me.
Theresa

Nice...thank you for the information! My prescription plan doesn't cover VSL#3, but DOES cover the VSL#3 DS. I am so glad this discussion board is available to the public. Thank you again for your research.

Oh yeah, if it was not for the NDC number, I would of been told it was not covered under my plan.

LionsPride -
Thanks for your research and help. My pharmacy, Walgreens didn't have it on hand but are getting it, my UHC insurance plan covers it plus my Internist prescribed it for me.

I have not had pouchitis yet. I'm planning on taking one packet per day. I'm trying to avoid getting any infections and have been taking OTC probiotics before I had the surgeries.

According to your researsh do you think 1 packet a day is a good maintainance amount? You know more about this than my doctor, who suggested Align, and I appreciate your opinion.

Thank you for all your help!

Lionspride- Congratulations on the upcoming nuptials! This is a great resource. I'm sure it will be useful in many months to come.

I have been taking VSL #3 for a few months now. I take one packet in the morning. This has worked for me so far. I have seen improvement in my frequency and urgency. I have not had pouchitis, but wanted to avoid it as best I could. I pay $86 per box of 30 from the VSL website. This includes the shipping.

I have not looked into VSL #3 DS too much. I did call me insurance company who said they did not cover it. I don't think that is the case though. The person I spoke with had no idea what I was talking about. If it did becomae a problem, I would ask my doctor's office to write a letter to the insurance company to try to get it covered.

Karbear - Thanks for sharing your dosage.

LionsPride - Congratulations!

Thanks everyone. Glad you're finding this useful. Wedding went great (3/26) and i haven't forgot about finishing this post but have been busy.

A note on probiotics in general. There are many you can take, this isn't a comment on VSL's effectiveness vs the rest. But should you research them and decide to use VSL, as I have, this guide can help you.

LionsPride - Thank you. When I found out this was the only one my insurance company would pay for and looking into some others I found your writing very useful. I know you are just passing on your research and are not giving medical advice.

I'm glad everything went well and wish you all the best!

LionsProde,

Your info in this post is what got me covered for the VSL #3 DS. Thank you so much for taking the time to post all of this info.

The NDC# is what ultimately did it. I was denied at the pharmacy, but after calling my insurance provider and providing this info, they put it through.

Thank you again.


Derek

Thanks!! Went to last Dr. appt. armed with this info. Also had called our insur. and had them check every # and name of VSL and got the code that they said they would cover. To my great surprise, the Dr. had this little info sheet to give us. Pix attached.

VSL3.gif (237 KB, 36 downloads)

sjb - very interesting, wonder why your doctor hadn't prescribed it to you before. My internist prescribed it because I asked her, after checking out with my insurance and drug store - didn't even ask the surgeon.

Something interesting happened this week. I had surgery Tuesday and the nurse told me if I wanted to take it I had to bring it from home as the hospital didn't have it. I have never heard of a hospital telling someone to bring something from home to take. Maybe because it's a "medical food".