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Vsl#3 insurance coverage

Does anybody able to get insurance cover the cost of vsl#3? Our GI went ahead and prescribed this on our behalf but safeway pharmacy can’t fill it. VSL asked us to try walgreens but not sure if insurance will pickup the cost.

Getting insurance to cover is a long shot from what I’ve read.

FYI, Vsl#3 was recently in the news for getting in some legal trouble. Basically, the guy who invented Vsl#3 retained rights to the formula. He left Vsl#3 in 2015 and began to sell this formula as Visbiome. Vsl#3 had to alter the formula and what got them in trouble is that they continue to claim that it does all of the wonderful things that are attributed specifically to the old formula. Basically, any prior studies involving Vsl#3 are talking about the product that is currently sold as Visbiome and NOT the current Vsl#3.

jtb,

My impression from that was a bit different may be I am mistaken. The inventor left vsl#3 and created visbiome with exactly the same formula but dairy based and vsl#3 is dairy free from the beginning.

This thread talked how insurance covered vsl#3 about 6 months ago, so curious if anyone else had luck.

Here’s an article about the suit: https://www.businesswire.com/news/home/20181126005445/en/Maryland-Federal-Jury-Unanimously-Finds-Probiotic-Sellers

I thought the difference was something insignificant like corn starch added to the new VSL#3 to not infringe on the original product (now Visbiome), but this study suggests there may be more substantial differences: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5681494/. I believe that the US manufactured product in this study is what is sold in the US as Visbiome and the Italy manufactured product is what is now sold as VSL#3.

My original comment about insurance balking is based on a number of people in the facebook groups commenting about how they have to pay out of pocket for prescription VSL#3 and Visbiome.

I checked my current Flexible Spending Plan rules and seems that it is eligible expense if valid prescription for specific condition.
So while not insurance coverage, at least hefty discount (40%?) via employer provided FSA.

jtb,

its really interesting and thank you for sharing that. We are asked to try from a local specialty/compounding pharmacy to see if that goes thru insurance and will let the group know of the outcome.

Ted,

We will give the FSA approach a shot and its good advice.

We got VSL #3 covered by BCBS in NC. It will get coverage if you have ulcerative colitis Bc it is an approved treatment. Without insurance it was like $500 a month. We went to CVS.

For the year- if you are going to hit your max out of pocket on procedures-wouldn’t it make sense to pay out of pocket for it regardless, knowing you will spend that amount?

I think it is worth it. We got samples from our GI doc in Charlotte (he didn’t know what vsl 3 was…I asked his nurse if they could get it and she knew they already had it and gave me bunches of samples they didn’t use)

I got coupons from the company too. Hope this helps.

Hi Mommymoses,

That’s good for you. We tried from several locations in walgreens, cvs and insurance declined saying its not covered under our employer plan, which is good one. Ours is BCBS of Michigan and we live in california.

Ted,

FSA declined initially but after a call they approved using FSA for this but asked us to call them every month to get reimbursed.

jtb,

You are absolutely right that visbiome is the actual one that’s studied in all of those earlier clinical trials. Dr.Yinka Davis also confirmed this. We have switched to visbiome now.

I got last week 3-pack of VSL#3 DS (ie 60 bags).
Official list price in VSL site is $398.
My local pharmacy has it at $360 or so, but manufacturer coupon gives $80 discount (see their Facebook page).

So after all the discounts and using FSA pre-tax money, I think my monthly VSL cost is about $50 or so (half bag per day).

I will leave this comment for anyone else who wants to know the differences between vsl3 vs visbiome and the updates from current litigation. Thanks @jtb, your comment above led me to look into this more closely.

https://www.visbiome.com/blogs/visbiome-vs-vsl-3

  • In the United States (US), seven major wholesalers of the VSL#3 product in the United States have recently decided to discontinue purchases/sales of the product—Amazon, Cardinal Health, McKesson, CVS/Caremark, Walgreens, Costco, and Rite Aid.
  • In Canada, the VSL#3® product was removed from the market , effective November 15, 2018.
  • Six universities in the US and Europe (including Stanford University, Emory University, University of Wisconsin-Madison, and University of Louisville) have halted human clinical trials using VSL#3 in response to the very serious public health concerns that have been raised.
  • As of this publication date, six published comparative studies have found stark differences between VSL#3 containing the De Simone Formulation and the new “knock off” product.1,2,3,4,5,6
  • The European Society for Clinical Nutrition and Metabolism (ESPEN) issued a correction to its guidelines for Clinical Nutrition in Inflammatory Bowel Disease7, withdrawing the trademark “VSL#3” and replacing this with the generic term “De Simone Formulation”.
  • The peer-reviewed journal, Medicine, issued an erratum replacing “VSL#3” with “De Simone Formulation” in the article, “The clinical effects of probiotics for inflammatory bowel disease: A Meta-analysis”.8
  • In Germany,the District Court of Hamburg, Germany ordered the local distributor of VSL#3 (Ferring) to stop making a series of claims in reference to the effectiveness of the current probiotic formulation commercialized under the brand VSL#3®
  • The authors of the sole positive comparison on original vs knock off VSL#3 issued a correction to their original article, which concedes that their primary analysis was not performed using commercial VSL#3 .10