Reply to "Pouch Endoscopy Results?"

BlueFlame posted:

So, are you saying Xifaxan worked for you/didn't stop working....but insurance wouldn't cover the amount you needed....and instead covers Remicade?

Yes, that is essentially correct but I will explain.  I have a group health plan with Anthem Blue Cross/Blue Shield that has a $5000 deductible and a $6500 out of pocket maximum.  Through my employer.  I chose that plan for 2 reason: (1) no payroll deduction if I chose the high deductible plan; and (2) Because Remicade has a cost savings program called Remistart, all of the $10,000 for each infusion gets paid by my insurance except for $420 towards the first infusion which was applied against my deductible.  Remistart is a Credit Card that Remicade sends you that pays for the medication.  Those payments count towards your deductible and out of pocket payments, even though you are not actually paying them.  Being on Remicade is frankly saving me money!

With regard to Xifaxin, the problem is that it is typically prescribed in a short course as a remedy for travelers diarrhea. It is not typically prescribed chronically.  So they will cover about 3 weeks a year and then pull the plug, because it is not seen as a viable treatment for anything other than travelers diarrhea.  It's also a designer antibiotic that is not systemically absorbed, meaning that any side effects will be non-systemic and theoretically only in your gut. Remicade, on the other hand, is widely viewed as a drug that works for chronic IBD.

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