Rationing drugs due to insurance concerns

Let’s face it.  Stocking up on drugs is not an idea that makes your insurance company happy.  But the challenge of having the right drugs on hand at the right time is adding to worldwide migraine pain.

This is actually a study from June 2007, but it’s worth looking at.  Dr. Robert A. Nicholson, assistant professor at Saint Louis University School of Medicine and School of Public Health headed up a study of 233 migraine sufferers who took triptan drugs.  Here’s what he found…

42% of patients said that their insurance plan restricted the number of triptan doses covered each month.  37% said they had a prescription for triptan drugs, but hadn’t filled it because of the cost.

Of those with no limitations, 79% took a triptan at first sign of a migraine attack (as most doctors recommend).  Of those with prescriptions, only 49% took a triptan at the first sign of an attack.  Of those who took a triptan right away, 51% said that migraine had a severe negative impact on their lives.  But of those who hesitated to take the drug, 79% said that migraine had a severe negative impact on their lives.  In fact, one in three of these people ended up in the emergency room at least once in the previous 12 months.

In summary – if someone’s insurance company is limiting their triptans per month, or if cost is keeping people from using them, they have more severe attacks and more frequent visits to the hospital.  Not only does this seem bad for health, it doesn’t seem very cost effective for the insurance company.

The good news is that triptans, when used right away, are working.

One more interesting note.  Dr Nicholson notes that many people delay in taking migraine medication because they want to be sure it’s really a migraine.  Don’t worry, he says.  Statistics show that your first guess is almost always right.

What can we do about this?  Look for another insurance company?  Find other alternative treatments (for when your pills run out)?  What’s your strategy?

Read more:  Insurance, Cost Issues Prevent Many from Treating Migraines

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2 comments… add one
  • michelle Sep 26, 2012

    The insurance companies have $$$ in there eyes. They keep changing the thevari drugs they will pay for also because they know we will have to change to what ever they decided to cover or go with out and suffer.
    I come from a family of migraine sufferers. Each of use varies in degree of suffering. Just this past year one of my sister’s medication was changed more than once due to insurance mix ups.

  • Papago76 Sep 29, 2012

    Hoard hoard hoard. My insurance plans have always limited my monthly supply of both sumatriptan tablets and nasal spray units. Makes you wish these headaches upon those who make those decisions, mean as that sounds. Ask your doctor to add plenty of refills to your prescription, then continue to have it refilled when you are not having headaches until you amass a good quantity of drugs. Sumatriptan tablets have quite a long shelf life, and while the nasal spray expiration date isn’t so long, it is still effective past that date. Right now I have about 150 doses of sumatriptan tablets (I take 1/2 of a 100 mg tablet, studies showed 50 mg is as effective as 75 or 100 mg dosing, cut the 100 mg tabs in half) and about 30 of the nasal spray 20 mg units.

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