insurance companies can be real ****** well, you know what I mean!it is a good idea to work with the office staff of your doctors office. they can request a "prior authorization" from the insurance company. they fill out a form, and fax it to the insurance company. On the form it is VERY important for them to say that the patient (you) has failed on other treatments such as antispasmodics, antichlorgenics, and antidiareals (Imodium).the insurance company is required (by law) to answer the request, and give alternative treatment options (ha!) It is sometimes hard to get your doctors staff to go through this trouble to get the script covered, but if they are nice they will try! it may take a couple of days, and you will probley have to pay a co-pay ($5 - $50 per month) but it beats the heck out of $147!!! also, ask for lots of samples while you are waiting to get your script covered (why not, it dosen't hurt to ask!)good luck, and may the insurance company executive who deny coverage have a real bout of "D" on their next night out on the town