XIFAXAN has the best insurance coverage of all medications approved for IBS-D1
The resources below can help you find coverage for some of your adult patients.
Look up coverage in your area, make the PA process simpler, and learn how to avoid denials for appropriate patients taking XIFAXAN. When needed, please see examples* of a Letter of Medical Necessity and a Tier Exemption Request.
Get XIFAXAN coverage by plan in your area
The XIFAXAN Coverage Lookup Tool can help you determine how a patient’s prescription drug insurance covers XIFAXAN in your ZIP code.†
Find helpful information if your patient's plan requires a PA
Simplifying the PA process for XIFAXAN
Being proactive with PAs leads to higher approval rates.1 View the brochure below to see simple directions for submitting a PA for XIFAXAN when needed.
View PA Considerations Brochure
Plus, learn how to avoid common reasons for a denial for appropriate patients by expanding the chart.
Improve the PA process for XIFAXAN with CoverMyMeds
In 2020, PAs had a 78% PA approval rate for IBS-D when submitted through CoverMyMeds.1 To start a PA for XIFAXAN, you can go to covermymeds.com or call 1-866-452-5017.
Letter of Medical Necessity*
For both commercially and government insured patients, your practice may need to file an appeal if a patient is denied coverage for XIFAXAN. Please fill out and submit a Letter of Medical Necessity on behalf of your patient who has been prescribed XIFAXAN.
View Sample Letter of Medical Necessity
| Remember to ADD the following information: | |
|---|---|
| Age | Patients must be 18 years or older |
| Diagnosis of IBS-D | ICD-10 code is K58.03‡ |
| Dosing for IBS-D | XIFAXAN 550 mg 3 times a day for 2 weeks; #42 tablets2 |
Document any and all prescriptions (eg, antispasmodics and antidiarrheals) or over-the-counter medications that the patient has tried and failed for step edits.
Find ways to help your patients save on copays
Help your eligible|| patients save on XIFAXAN
90% of eligible||, commercially insured patients who had coverage for XIFAXAN paid $10 or less when a copay card or eVoucher was applied in 2020.1
Patients who need assistance with their monthly copays can call 1-866-XIFAXAN (1-866-943-2926).
Find practice and patient resources
View efficacy data from clinical trials >
IBS-D = irritable bowel syndrome with diarrhea
HE = hepatic encephalopathy
*NOTE: These sample forms are provided for informational purposes only. As a reminder, it is the responsibility of the healthcare professional and/or their office staff, as appropriate, to determine the correct diagnosis, treatment protocol, and content of all such forms for each individual patient.
†Salix Pharmaceuticals does not guarantee coverage or reimbursement for the product.
‡The ICD-10 Codes and all other patient-access-related information are provided for informational purposes only. It is the treating physician’s responsibility to determine the proper diagnosis, treatment, and applicable ICD-10 Code. Salix Pharmaceuticals does not guarantee coverage or reimbursement for the product.
§Formulary status subject to change.
||Patient is not eligible if he/she participates in or seeks reimbursement or submits a claim for reimbursement to any federal or state healthcare program with prescription drug coverage, such as Medicaid, Medicare, Medigap, VA, DOD, TRICARE, or any similar federal or state healthcare program (each a Government Program), or where prohibited by law. Patient must be enrolled in, and must seek reimbursement from or submit a claim for reimbursement to, a commercial insurance plan. Offer excludes full cash-paying patients. Maximum benefits and other restrictions apply. Visit https://xifaxan.copaysavingsprogram.com/ or call 1-866-XIFAXAN for full eligibility criteria, terms and conditions.
of eligible||, commercially insured patients who had coverage for XIFAXAN paid $10 or less when a copay card or eVoucher was applied in 2020.1
INDICATIONS
XIFAXAN® (rifaximin) 550 mg tablets are indicated for the reduction in risk of overt hepatic encephalopathy (HE) recurrence in adults and for the treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults.
IMPORTANT SAFETY INFORMATION
- XIFAXAN is contraindicated in patients with a hypersensitivity to rifaximin, rifamycin antimicrobial agents, or any of the components in XIFAXAN. Hypersensitivity reactions have included exfoliative dermatitis, angioneurotic edema, and anaphylaxis.
- Clostridium difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including XIFAXAN, and may range in severity from mild diarrhea to fatal colitis. If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued.