A patient called in last week asking about Vancocin capsules. She had been calling everywhere trying to find them, with no luck! We discussed how they can be difficult to find and how expensive they will be even if she does find them. She was happy to hear that there is an alternative that will help her save mucho bucks!
First some background…
Vancomycin is an antibiotic that is most commonly used IV to treat methicillin resistant staphylococcus aureus. However it can also be used orally to treat clostridium difficile (c.diff).
C.diff is an intestinal infection that occurs most often in hospitalized patients after treatment with broadspectrum antibiotics.
Treatments for C.diff include Flagyl (metronidazole) and oral vancomycin. Typical dose of oral vancomycin is 125mg four times a day for 10 -14 days.
Cost? Vancocin capsules cost about $1,800 for a 14 day treatment -pricey no?! That is the cash price but even with insurance the copay is typically wicked high! Well, good news -there is an alternative. A hospital outpatient pharmacy (yes, most hospitals have outpatient pharmacies) can provide the IV vancomycin liquid that can be used orally and is much less expensive because it is available in generic. How less expensive….about $40 for a 14 day treatment (cash price) -that is a savings of about 1,760 bucks!
I have c.diff -now what? Talk with your physician about the options -Flagyl (metronidazole) is a great option because it works well and is on the $4 list at Walmart and Target. If your physician decides that oral vancomycin is what is needed, then call your local hospital and ask to speak with the outpatient pharmacy. Typically, the pharmacy will dispense small syringes filled with clear fluid (vancomycin)…the largest amount should be 15mls (1 tablespoon). Small warning, it doesn’t taste that great -so you may want a chaser after you take it but it does the job and at a fraction of the cost!
How to make it easy:
1) Ask your physician to write for “IV vancomycin fluid 10mg/ml -12.5ml by mouth four times a day for ____days”
2) Call local hospital and ask if they have an outpatient pharmacy -if so, have script filled there (retail/community pharmacies will most likely not be able to provide).
3) Take medicine as prescribed! And take a deep sigh of relief that you didn’t have to pay $1,800!
Have you taken oral vancomycin? What do you think -please leave a comment!