Irritable Bowel Syndrome and Digestive Health Support Forum banner
1 - 9 of 9 Posts

·
Registered
Joined
·
4 Posts
Discussion Starter · #1 ·
I was excited to try Zelnorm for my IBS-C. I have tried everything including Linzess, Trulance, Magnesium, a host of Fiber supplements, gluten free, dairy free, olive oil shots, coffee enemas (yup you read that right), and I could go on and on...…. Nothing has helped my IBS-C. However, Zelnorm after a 2 week sample pack seems to be doing a good job. So, I got a script and happily skipped to the corner Walgreens to find out that the monthly tab will be $467. My insurance will not cover the cost at all. I have searched high and low and even contacted Novartis (the drug maker). No discounts atm. I have contacted NeedyMeds.org and they did a web check to see if there were any discounts online and nothing seemed to come up. As excited as I am to begin this medication, the price is a bit high and will dent my budget severely. Does anyone know of an avenue I haven't pursued to get this medication a tad more reasonably priced?
 

·
Community Manager
Joined
·
13,198 Posts
will your insurance cover it if your doc submits a prior authorization to them saying that you've tried and failed everything else and that zelnorm is a medical necessity for you?

that's what my doc did for me back in the day when zelnorm was first available. my insurance refused to cover it at first but when my doc submitted a prior auth then they decided to cover it.

that's really a shame that there are no discount coupons online for zelnorm. a lot of the other C meds offer those "savings cards" and/or "patient assistance programs". i sure hope novartis gets a clue and starts to offer something like that.

good luck. hope you can find a way to get the price down.
 

·
Registered
Joined
·
4 Posts
Discussion Starter · #3 ·
Apparently my doctor submitted a written report with all my prior medications. Basically, the answer was Zelnorm is specifically outlined as omitted coverage under my insurance. Oh the joys of medical coverage!! Thanks for your input! I appreciate it!
 

·
Community Manager
Joined
·
13,198 Posts
oh so sorry to hear that! how very frustrating! that's just plain wrong that your insurance won't cover it.

you could call all the pharmacies in your area just to see who has it for the cheapest price. prices can vary quite a bit among pharmacies--sometimes as much as $100.00. that's what i found out when i had to pay for my cat's insulin.

well, zelnorm is a new drug. hopefully in time your insurance will decide to cover it.
 
  • Like
Reactions: sydmo

·
Registered
Joined
·
4 Posts
Discussion Starter · #5 ·
Oh great idea! I will try to see which pharmacy is the cheapest and maybe one will have a discount program as well. Thanks for the input!
 

·
Community Manager
Joined
·
13,198 Posts
good luck!

you and your doctor could also try appealing your insurance's denial of the prior authorization that you doctor submitted. i know there's an appeal process. i've used it from time to time. you submit a letter to your insurance company appealing their decision. in my case, my insurance company actually sent me a form i could fill out and return to them for an appeal.

on another board that i read, a woman was discussing her problems with her insurance company denying coverage of motergrity. here's part of that discussion:

person replying to her: "i don't know anything about this program, but perhaps it's helpful & more cost effective?
https://prescriptionhope.com/motegrity-prucalopride/

another suggestion i have is to check Costco's online pharmacy or their warehouse pharmacies close to you and ask for an out of pocket price. their online pharmacy costs might be less than warehouse. i found Ondansetron ODT to be affordable ($40 for 90tablets) from them since my insurance coverage in 2019 is only 27tabs for 3 month Rx. others have mentioned Kroger's Rx pharmacy program if there's one near you."

OP: "Well, it took several denials, appeals and then I wrote a letter and submitted a member appeal and finally the nurse who works with my doctor called to say they received the letter stating my insurance will cover the Motegrity. I wasn't giving up

here's the actual link to that discussion. you have to register to read it.

https://www.inspire.com/groups/agmd-gi-motility/discussion/motegrity-prucalopride-now-avail-in-the-usa/?page=last#replies
 

·
Registered
Joined
·
4 Posts
Discussion Starter · #7 ·
Thank you Annie7 for all the info!!! My Doc just started me on a sample pack of Motegrity so if that works then this may be my solution with the info you sent!! This forum is wonderful! So far Motegrity is good (day3). Not quite like Zelnorm even though both meds work the same (right?). But I am only a few days in and need to give my body time to adjust.

I hope Motegrity can be a helpful solution for many of us!
 

·
Community Manager
Joined
·
13,198 Posts
thanks for the update. that's terrific that motegrity is working for you! hopefully it will work as well as zelnorm did. and yes, you're right--they are similar meds and they both basically work the same way.

good luck with everything!
 

·
Registered
Joined
·
2 Posts
Hmmm, have you tried looking for this product on eBay or Amazon? Perhaps someone sells Zelnorm cheaper than $467, in addition, there are sites where you can get a discount on purchases at various stores. I think you should find more information about it. I often use the service DontPayFull: Coupon Codes, Coupons, Promo Codes, Free Shipping and Discounts if I need to buy something at a discount with a promo code, it has always saved me from spending. There are a lot of useful sites and platforms on the media that we don't even know about, so I think you should pay attention to that. I sincerely hope that you can find this medicine at a discount, take care of your health).
 
1 - 9 of 9 Posts
Top