Oral Vancomycin

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!

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Comments

Thank you! Thank you! This info was invaluable to my parents as it was going to cost my Dad $1900 for oral vanco. When the hospital case manager called his SS secondary insurance and explained that this Rx was needed to help him in his continual battle with CDiff. They agreed to cut him $800. Still, $1100 is quite a lot to someone on limited income! When the case manager heard what I’d found from your post, she investigated further and found a compounding pharmacy and it cost $125 !!! Wow! What a difference! Thank you SO very much for this post!

PS: The Case Manager thanks you, too! She said she learned something that will prove quite valuable to many others whose paths she crosses in her field of work! She had no idea!

Hi Patty,

Thank you for leaving this comment! It makes us so happy when we hear that we are helping! And I am SO happy that this worked out for you and your Dad. I am glad that you and the Case Manager will be able to spread the knowledge :)

Take care -and I hope the vanco helps your dad with treating the C.Diff.

Nova

Nova Simpson, Pharm.D.

Hello my name is karrie and my grandmother has clostridium and the only medicine she can take is vancomycin and it was 700$ with her insurance. she is on a fixed income so this was way beyond her budget. After reading this post i did excatly what is says and called the out patient pharmacy and they said they couold do it for 80$!!! wow!!! Thank you so very much! my grandmother can now get the medicine for a fraction of the regular price. Everyone out there please listen to this post it is truly amazing and very insightful. Thank you again for helping my grandmother and i hope people take this seriously because you save hundreds of dollars and get the same thing! thanks!!!!

Hi Karrie,

Thank you so much for sharing your story! I am so glad to hear that it worked out so well for your Grandma!

Take care,
Nova

I just got out of the hospital with c.diff. I took the liquid ever 4 hours. Best chaser is orange juice… And if you have your pharmacy break your Rx down to 20 pills at a time your insurance will cover it. Mine did….hope the info helps

Thank you so much for this information. My father has C-diff, he had emergency surgery and had his colon removed for this 2 yrs ago. The C-diff has returned and is in his small intestine. He was discharged with an RX for Flagyl and Vancomycin capsules which cost $1040, so the DR said just take the flagyl. Now two weeks later he is sick again, not eating, drinking. I found your advice, and let him know. He got the new RX for $27.00!!!!! It disgusts me that the pharmacy or discharging DR did not advocate for him and get him the proper medication. Thank you!!

My Mom has C-diff for the third time, Vancomyacin is so Godly exspensive!! If the Hospital does not have an outpatient pharmacy then what do you suggest?
She had it filled with a compound pharmacy and try charged her $400.00 but that’s soo spendy!! My mom is disabled and on a fixed income. Please help! We live in MN.
This Vancomyacin is the liquid form and she takes it 4x a day, but still the exspense is ridiculous!!

Hi Ericka,
The compounding pharmacy has saved you some money but $400 is still absurdly expensive! I would recommend asking someone at the hospital about what hospital in your area has an outpatient pharmacy. You can even call the main phone number, ask to speak with the “inpatient pharmacy” when you are transferred to them, ask which hospital has an outpatient pharmacy -they usually will know. If the outpatient pharmacy seems too far, I would call anyway and request them to mail the medicine to you!

Good luck and I hope your mom gets well quickly!
Nova

Nova Simpson, Pharm.D.

Thanks im taking vancomycin right now in the hospital and thats what I will be 4aking when I leave ! This was very helpful!

Very valuable info- helped me get the ball rolling to get my sister’s prescription. Patients who do not have insurance are discharged from the hospital with scrips for extremely expensive meds and they are at a serious disadvantage: they may have very little experience in accessing services. Being ill and being told your prescriptions will cost thousands of dollars is not only very frightening, it is demoralizing. I spoke with many people today with the best of intentions and a genuine desire to help my sister; but it was the concrete information I found on your site that got the process started. Thank you so very much!

I had c-diff for 15 months during 2010-2011. During this time it recurred once.
My Ins. pd $2500 -$5000 per month..I pd. a co-pay of $75.00 per mo. I now have c-diff again and a diff. ins. They are fighting this and my doctor is now prescribing it (in IV form) through a CVS pharmacy for $188.00 per mo and my co-pay being $58.00. This pharmacy is in Cypress, Ca. I live in Long Beach, Ca.

Please respond and let me know how it’s going since this last post.

Gratefully, Cathy Grimes

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