It’s crazy expensive

my insurance at the time would not approve it (Florida blue). Is Cigna covering this and you have a high deductible or are you getting  the non covered price?

Medicare part d drug plan does not cover it.

can your doctor give you some samples?

it would be nice to know if it works before investing that kind of $$$$.

can you contact the drug company and see if they have a program to get it at a lower cost?

finally, can you ask your doctor for an alternative?

My Aetna insurance covered it but only for a few months. I then ordered a generic manufactured in India through a Canadian pharmacy.  I think it was costing @ $130 for a month supply.  I used

http://canadianpharmacyking.com/

but there are others as well.  Dr faxes the order and they ship to your door  - you can get brand or generic from various countries in various quantities through these pharmacies.

I have considered trying it again.  It seemed to work, then didn't work as well after the pause between Aetna covering and re-starting with the new supply.    Doctor then substituted Tinidazole, which I am taking at about the same out of pocket cost at the local pharmacy on my current Blue Cross/Blue Shield plan. But still can't get off the Cipro!

You can appeal the insurance company’s denial based on medical necessity, and even escalate to your state’s insurance regulator, but other than the initial appeal this can take a long time and requires some uncompensated support from your doctor. I did this successfully for VSL #3 DS, but it took almost a year.

Alternatively you could try a different antibiotic or a combination of antibiotics. Cipro and Flagyl together worked for me when neither alone did the trick any more.

I had great success with Xifaxin. It is expensive though. My GI doc always had a manufacturer coupon for me. And sometimes samples. I would ask about that or go directly to the manufacturer for help.

Best of luck to you!

Here’s the link to the page with information about keeping Xifaxan costs down: https://www.xifaxan.com/hcp/ibsd/access-and-savings/

Another thumbs up for the suggestion Canadian pharmacy for Xifaxan.  I live on the west coast of the US, so the Canadian pharmacy I would use is based in Vancouver, B.C. Holler if you want a name and number.

Like Scott mentioned, insurance companies have an appeals process. My insurance company requires my doc to prescribe 3 out of 4 possible solutions and each of the three courses must either fail to solve the problem or I need to experience a strongly adverse reaction to the medication. After 3 failures, the insurance company will consider approving a 14 day course of Xifaxan with a lifetime maximum of three courses. After vomiting after 5 days on the first course of medication, and experiencing firehouse diarrhea with the second, it's tempting to go with Oh, Canada before I attempt the third course of meds!

Just curious if you can tell us the three medications that they are forcing you try?

thanks

@New577 I can't find my Xifaxan insurance denial paperwork at the moment, but cut and pasted below is a sample from the internet. Bear in mind every insurance plan has different criteria. For example, the insurance criteria below includes trials of diet modification as well as trials from two additional groups of meds. My insurance required trials from four groups of meds, including the group of drugs in the metronidazole (Flagyl) family, but no dietary modification trial. Go figure.

                  " Member must have failed dietary modifications [e.g. lactose restricted diet, if lactose intolerant; exclusion of gas-producing foods; low carbohydrate diet, and elimination of fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs)]. 

Member must have a history of trial and failure, contraindication, or intolerance to ALL of the following:

Two-week trial of antispasmodic agents (e.g. dicyclomine) o

Six-week trial of Tricyclic antidepressants (e.g. amitriptyline, imipramine)"

That’s insane to me.  If it were me, I’m not waiting so long. If u are convinced it will work, I would do the Canada route.

when I had private insurance it was not covered at all. I am on Medicare part d now, so xifaxin is not not covered on any of the plans. Fortunately, bactrim worked for my SIBO.

I will say that btw the denials and appeals it was very frustrating and before I knew it weeks passed by.

I am on Medicare as well and will be ordering from Canada when I need my next refill. I did originally pay over $1000 for a 30 day supply. Now they have denied me.

This is an old post, but I pay $350.00 a month at israelpharm.com