Meds Meds Meds and Botox??

I posted a little while back about the insurance company denying my Rx for Effexor XR for treatment of migraines and occipital neuralgia.

My neuro sent out an Rx for the next choice, but they denied that too. They will not cover any antidepressants for migraine treatment.

I was given a muscle relaxer to try in the evenings, but it makes me so sleepy all day after I wake up. I was given this to hold me over while the NP works with my neuro to come up with some options.

I hope they come up with a good plan- she mentioned the infamous Botox as an option and even said they would use samples from the drug company since she already knows my insurance won't cover it. I am on the fence with the botox due to the side effects. Decisions, decisions. I will definitely be picking apart all of the botox threads on here.

I am staying at my halved dose of topamax. The memory loss got too much to bear.

I still haven't even been able to use my sumatriptan injection pen... the last bad M I had I couldn't use it because I already had taken a triptan that day.

It will definitely be interesting to see what they decide. I see them in a month!

Hi there! If they won't cover any anti depressants for migraine, I assume they won't cover anything that isn't FDA approved for migraine. Your best bet is researching which migraine preventatives are cheap generics, such as Amitriptyline and Inderal, or are FDA approved for migraine, such as Topamax, Depakote, Inderal, and Timolol (all also generics). If its cheap enough, just pay cash for it. Many meds are available for less than $20/month. Some are even on pharmacy's $4 lists.

You can research an estimated cash price on a medication at a website such as pharmacy.com (usually the price of any mg of a pill is about the same). There are other muscle relaxers to try which might not be as sedating (or not at all). Or, you could try a smaller dose or taking it a bit earlier in the evening (plus be sure to allow at least 8 hours to sleep).

Actually, Botox is FDA approved for chronic migraine. If you have headaches 15 or more days a month, you have tried a good number of treatments, and your doctor is willing to write the diagnosis of chronic migraine, insurance has to cover it. Note that even if the doctor is willing to donate the Botox, check what they will charge you to inject it. Typically the injection costs (doctor time and supplies) are not applicable towards an office visit copay.

Just the doctor for each round of Botox for me was a few hundred bucks (and I paid my coinsurance percent). The meds were about $1,000 each time for me in case anyone was wondering (150 units?). They likely couldn't just write it down as an office visit as they have special codes for everything and even something as simple as the injection kit they use for it (cleaning supplies, needle, etc) is typically tracked in the system and must be billed for.

So, what may seem like a free treatment could end up costing a lot of money. Actually, the side effects of Botox are a much lower rate than any commonly used preventative med. As long as your doctor is trained in it and does the procedure regularly (well practiced), I think it is very very low risk. I think you have some good med options on the cheap if you are creative. Its sad your insurance won't cover any anti depressants for migraine (I assume as they aren't FDA approved for it). Best wishes.

BabySeal said:

I was given a muscle relaxer to try in the evenings, but it makes me so sleepy all day after I wake up. I was given this to hold me over while the NP works with my neuro to come up with some options.

I had the same problem with my muscle relaxant; Baclofen. I now use it every other day or every third day and that seems to work better for me, since it does not build up in my body.

Just a thought for your consideration. However, your level of pain may prevent you from doing the same.

Martin

Tortisegirl- thanks! I didn't even think of any other costs that could be associated with the injections (whenever, and if, they would occur). I am definitely going to ask all about that at my next visit.


Martin- Thanks for the recommendation, I gave it a try! I skipped a couple days but I was still groggy Was worth a try!!