Dr. Keith Roach: It pays to check into lower cost meds

Dear Dr. Roach: My husband recently was diagnosed with ulcerative colitis. He was prescribed Lialda, and also was told that he would have to take it for the rest of his life. He is scheduled for another colonoscopy in a few weeks.

This is a very expensive medication. We are senior citizens with a limited income. It seems there is a generic form of Lialda; however, his doctor did not prescribe it for him. He is feeling somewhat better on it. I know he is concerned about how he will be able to pay for it. His dosage started with four pills a day. His doctor has lowered it to three at this time.

Is there a less-expensive medication available? His first prescription two months ago put him in the doughnut hole. The first of the new year, he will be ready for a refill.

If there is any advice you can give us about our new condition, we would really appreciate it, as it is quite overwhelming for us at this time. We will have to live with it and manage it as we go.

-- Anon.

A: Ulcerative colitis is one type of inflammatory bowel disease (the other type is Crohn's disease). It causes inflammation and ulcers in the colon, and increases long-term risk of colon cancer.

Lialda is a brand name of mesalamine, also called 5-ASA, which reduces inflammation in the colon. I would ask your husband's doctor about an old formulation of 5-ASA called sulfasalazine. According to my sources, in the U.S. Lialda is about $970 per month, and sulfasalazine is about $45 per month. Sulfasalazine is more likely to have side effects; however, one study showed that it is slightly more likely to prevent flares of ulcerative colitis. If he can tolerate the sulfasalazine, then that might be the best way to go.

Dear Dr. Roach: I am a 50-year-old female. How accurate are the results of fecal blood tests? In May, then July, I saw what looked like blood in my stool. My GP ordered the fecal blood test, three smears over three days. Results negative. Then in November I saw it again. My doctor said since the fecal test showed no blood, there is no blood.

My sister had colon cancer at age 45. I have had pre-cancerous polyps removed every three years for the past 10 years. Can I trust the fecal blood test results?

-- S.C.

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Dr. Keith Roach: It pays to check into lower cost meds