I need your help.
A longtime user of the site is looking for some insight into what might be going on with Asacol and Delzicol with regards to their healthcare coverage in the United States. Below is the email I received:
Hi Adam, I so appreciate your site! I’ve had UC since 1988 so it’s great to hear others’ experiences.
My question is about Asacol HD and Delzicol no longer being covered by insurance.
Do you know if this is an insurance company decision or the supplier decision…or both?
Like many others on your site? I’d done well on Asacol for years, but now that it’s changed to Delzicol, I’m not doing as well. My GI doctor gave me some samples of Asacol HD to try. Now I understand that neither of these medications are covered under insurance. I have United Health Insurance and their supplier is CVS/Caremark. The only one they still cover is Lialda which I’ve never tried, so I’m really hoping it works well. In my 25+ years of having UC, I’ve never heard of medications just being outright dropped from coverage.
Do you know if CCFA is doing any advocacy on this issue?
Laine from Arizona
**If any of you have ideas or information on this, please share a comment below!
Thanks for reading and have a great weekend,
**For those of you outside of the US, here is a brief introduction on how one aspect of the healthcare/insurance/patient system sometimes operates in the United States of America.
I started site shortly after being diagnosed in October of 2008 with severe pancolitis (when my whole colon was inflamed).
For me, it was a very rough start with severe symptoms. Getting bounced from medication to medication was not easy or too helpful. But, I did meet another UC’er, changes several parts of my diet, and of course the rest is history.
Leave a comment, ask a question, take advantage of our past experiences here, use the search boxes, they are your friends to0:)
I’ve written 2 different ulcerative colitis ebooks, you can check them out here.
And, the Free eNewsletter, which has important updates can be joined here.
My insurance is Anthem Blue Cross Blue Shield and they dropped this medication 2 years ago – I was doing very well with it. They will only cover Balsalazide Disodium. I was very worried how this would work, but have been pleasantly surprised.
When I inquired, it was due to the cost and they felt generics work just as well. Easy for them to say!
SAME INSURANCE SAME MEDS DIFFERENT STATE…NY…HAVE UC SINCE 72. CANNOT SAY IF LIADA WILL HELP BUT I WAS PUT ON OLD FASHIONED ORIGINAL UC MED AZULFADINE. I FIND IT SIMILAR BUT COAT YOUR BELLY WITH TAGAMET OR PROTONIX TO AVOID UPPER GI ULCER. ASACOL WAS MY WONDER DRUG DELZICOL MADE ME RELAPSE .HOPE THIS HELPS. IT IS REALLY FRUSTRATING AND WE HAVE 1 OF THE BEST INSURANCE.GO FIGURE.
If you have commercial health insurance you may be able to get the mess at a discount via this coupon
When I was diagnosed with UC I was put on asacol. At the time I had an insurance that covered it. Then when I turned 65 I was put on Medicare and switched to Humana for prescription drugs. They REF– USED to cover the asacol (and every other med I had been taking for years) and I wound up in the hospital 8 times last year. When I called the pharmacy to see how much it would cost if I paid for it myself the pharmacist said that with a discount card it would cost ….holy crap!!!!!!! (pun intended)
It would cost more than my social security check. I can suggest to you something that works fairly well for me……….VSL#3. its a probiotic that is specific for UC.
I wish you well and all of us who suffer from this horrible disease. God bless you all.
I’m having the same problem! My insurance doesn’t cover the Asacol ! I’ve been getting samples from my Dr office! I’m just afraid they won’t always have them ! Asacol the only drug that really works well for me ! We supposedly have great insurance! My insurance used to cover it years ago ! I have been diagnosed with UC in 2000 ! Was doing well for 12 years but lately I was having a really bad flare up with a lot of joint pain and a rash called Erythema Nodosum that people with UC can get ! As soon as I got my flare up under control that rash went away ! Asacol the only medicine that get my UC under control ! That’s why I’m considered if I can’t get the Asacol covered under my insurance!
I’m glad I’m not alone in this Deborah ! The pharmacy told me it would be 1000 to fill the Asacol ! Where can I get the VSL Probiotic??? Thanks for your kind words and God bless you also !
I had a United healthcare and they were dropping a lot of different medication. Now I have Blue Cross Blue Shield gold and I have had no trouble with dropped medications , in fact I usually have a zero co-pay.
We buy our own health insurance because we are self-employed and I think we made a good decision.
I lived in Europe for a while under socialized medicine and I can tell you that I think we are headed down the wrong path when insurance companies and not physicians decide through their coverage how we are treated as patients.
Hi Jessica………..I get the VSL #3 by prescription from my GI doctor……and my friend pays for it for me………..I “think” you can get it over the counter (but Im not sure). You can call your pharmacy and ask them. This probiotic is specific for Ulcerative Colitis and helped me. I hope you can get some and feel better :)
I also think that when youre working and paying into the system, yeah they’ll pay for your meds. But once you turn 65 and not working anymore and they have to give you the money back …then its “hell no drop dead”.
I wish for a cure for all diseases….but like I said theres no money in health. Sad….
I’m on Asacol HD, although my symptoms are currently running right through that and it is partially covered (I pay more than I used to, which is still a lot less than some of the posts) through my insurance which is an AETNA PPO (employer provided). I think my last out of pocket was $60 for 180 pills about 2.5 weeks ago.
I hope something comes through for you.
My UC improved when my MD switched me from Asacol to Lialda. I think Asacol is no longer sold in the US; Delzicol is the new version, which adds an outer capsule to the original Asacol (I think for patent reasons). I have the opposite problem: my insurance took Lialda off their formulary and now I have to go Delzicol, which I’m wary about. So be glad your insurance will cover Lialda!.
I was just told to take Delzicol and in my opinion the best way to go is to obtain a membership in Blink Pharmacy Card on the internet.