Just need to vent

[hilldk]

Why do doctors prescribe Xifaxan and send you on your merry way and then when you take it to the pharmacy, you have to get them to call the doctor to get pre-authorization from the insurance to pay for it? If they are prescribing more than 9 pills--which they are--they KNOW we need preapproval and should have someone in their office do it automatically. Instead of the pharmacy having to fax a request to them twice because it "magically" disappears from the doctor's fax machine last week when the pharmacy sends it. Then, the matter-of-fact office help at the doctor's office tells you that the doctor has to call the insurance (since when?) and he won't be in until tomorrow. I was supposed to start taking this tomorrow morning when my vanco runs out, not whenever they feel like getting around to it. I was quick to inform her that the pharmacy showed me their confirmation where they faxed it last Tueday and their office had not done anything with it. I started on this early, but the doctor's office has completely dropped the ball--just wait till I get to see him again next month! If one of them had what we have, they would be jumping around a bit faster to help! No wonder the American health system is in such a mess! Diarhea isn't a big concern for them--funny I don't consider c-diff in the same category as "diarhea." I told the helpless girl at the doctor's office I'd just pay for it and get reimbursed, but she told me I'd be okay until he can call it in tomorrow. Famous last words!!!

[nsewell]

I never had to get approval from the doctor for Xifaxan. I have BCBS for insurance.

[cindym]

Most likely you will be okay in just missing one day of meds. I have many times over the years I have been ill without problem.

[Christina]

I didn't have to get approval for the Xifaxan either but I have been told it's because it is not approved for the treatment of c-diff. Welcome to the world of experimentation! I've been there before too many times.

Good luck w/ the Xifaxan. I hope you have good luck with it.

[MaryT]

I actually changed my insurance company prior to starting xifaxan because the one i was on wouldn't cover for cdiff, so I switched to one that did.

[labgirl]

Have you tried asking your doctor for samples? My GI gave me several weeks worth once, and since I travel around to different physician offices each month, I've also seen xifaxan samples at Family Practice offices. I hope the xifaxan works for you. I took it after flagyl but kept relapsing. I may ask my ID doc if I can try it again if my vanco taper doesn't work. I had the same problem you had with them only covering 9 pills. The good thing was that the pharmacy didn't figure out they were only supposed to be giving me 9 pills a month until several months after the fact. My copay was $100 a week for the xifaxan! Good luck!

[hilldk]

The doctor has had to send them info on why I need more than 9 pills--the pharmacist said they will HAVE to cover it--he thinks they're crazy for fighting it since it is soooooo much cheaper than the vanco. I've had at least 5 prescriptions of vanco that cost $2400, but only $55 for my copay. It seems like they'd be proud to get one that's only a little over $200--the pharmacy told me I could pay for it, but the doctor said he wanted to make the insurance pay first, so I'm on vanco until they get it settled.

[cindym]

I WISH EVERY CEO OF EVERY INSURANCE COMPANY KNOWN TO CONTRACT CDIFF FOR AT LEAST A MONTH!!!!!!!!