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        New Message Board Archives >> Jan-Mar 2004 >> Imitrex & Ins. Co. problems...
        
(Message started by: manana on Jan 11^th, 2004, 7:54pm)

Title: Imitrex & Ins. Co. problems...
Post by manana on Jan 11^th, 2004, 7:54pm

I'm going thru a bad bout of ch's. My imitrex prescription is 25 mg tablet: Take 1 or 2 tablets by mouth four times daily as needed. I just picked up my last 9 tab supply & was told by the pharmacist that the Ins. Co. informed them that they will only pay for 9 tabs per month! I noticed on the Ouch website, an item titled "Cluster Headache Medications" which says: If you need more Imitrex than your insurance company will provide and your doctor is willing to prescribe it, you can contact Glaxo Smith Kline directly . . . 1-800-745-2967 . . . give them the information they ask for, your doctor's name & number, insurance company info, etc. and they will assisgn you a case worker who will contact your insurance company and hopefully get them to increase the number of doses."

Has anyone else had this problem? Has anyone tried working directly with Glazo Smith Kline & what kind of cooperation did you receive.

Thanks!

Title: Re: Imitrex & Ins. Co. problems...
Post by forgetfulnot on Jan 11^th, 2004, 9:25pm

Hi Manana - Bonana ;;D

# 1 Do you take any kind of preventative ?

# 2 Have you tried Imetrix Injections, the pills usually don't help clusterheads much.

# 3 That Glaxo deal is only intended to help people in dire financial straits, they change ther m.o. all the time, you would need to call the number to find out if the program still exists and if you would qualify.

#4 Have you tried oxygen?

# 5 Avoid a guy named jonny, bad news. ;;D

# 6 alternative to conventional treatments.
http://www.clusterbusters.com/

Lee

Title: Re: Imitrex & Ins. Co. problems...
Post by Mark C on Jan 11^th, 2004, 10:10pm

Welcome to the board. See if any of this helps. My Doctor wrote a letter to my insurance company and they increased the amount allowed. Its still not enough during a cycle but I can stock up during the off season.
Check the links below for more info.

Great post Lee!

http://www.drfeller.com/Mark/textclickhere.gif (http://www.healthcarerights.org/letters/appealmednec.html#Text)

http://www.drfeller.com/Mark/textclickhere.gif (http://www.cancersupportivecare.com/drug_assistance.html)

PFDAN's
Mark

Title: Re: Imitrex & Ins. Co. problems...
Post by Patrick_A on Jan 11^th, 2004, 10:16pm

Ok, I know some Ins. companies suck. But what i found to be the case in my experience is this..... My doctor wrote me a prescription and when i went to have it filled, i got the same crap as you. So i called my plan administrator and they said it was how the Doctor was writing the prescription. Soooo, I got my Doctor to re-write it as being needed for 4 times daily or something to that effect and i ended up with a massive amount of Imitrex.
Check with your plan administrator 1st to make sure they only allow you 9 pills per month. That isnt enough!

Patrick :)

Title: Re: Imitrex & Ins. Co. problems...
Post by OneEyeBlind on Jan 11^th, 2004, 10:21pm

You can try calling the phone number on the back of your insurance card. Find out what their procedures are when you hit the limit on your meds, and your doctor prescribes more.

With my insurance company, the doctor had to write "a letter of medical necessity" and fax it to the insurance company. The insurance company then has a board that reviews these claims. I was approved 3 days later for 30 shots a month. That's probably the equivalent (money wise) of about 120 pills or more a month.

Try the shots. They work miracles. The O2 also works real well for me, and I got that as well. You just have to call, BE NICE, and work the program you are given.

Good luck !!!!!!!! If you need any more help, PM me.

Title: Re: Imitrex & Ins. Co. problems...
Post by Patrick_A on Jan 11^th, 2004, 10:22pm

Ok, i kept this E-mail from my plan administrator. I know it might not apply to you, but remember, before i talked to them, I was getting the same runaround.

Here goes......

Today, Merck Medico stated if the perscription is written correctly- you should have no difficulty getting what you need.
Also, it would be much cheaper to do it mail order for 3 month supply.
For 1 month order to get you through:
Pills:
Imitrex, 100mg 2 p.o. every day for 30 days. 60 tablets.
(if you get over 21 days supply you will have to pay 2 co-pays. So, if you can get by with 21 day order for 42 tablets.you would only have to pay $16.00)

Spray:
Imitrex 20mg spray. 2 sprays every day for 30 days. 60 doses or 63 doses since in a 9 dose supply.

3 month Supply:
Pills: Imitrex, 100mg 2 p.o. every day for 90 days: 180 tablets (2 every day)
Spray: Imitrex 20mg spray. 2 sprays every day for 90 days: 189 doses (21 packs)

Patrick, who never has to worry about imitrex again, and dont mind sharing with my friends in need!

Title: Re: Imitrex & Ins. Co. problems...
Post by AlienSpaceGuy on Jan 11^th, 2004, 11:25pm

Hi manana,

Everything said in the other replies.

Plus, if everything else fails:

Imtrex pills come in 25, 50 and 100 mg dosage.
Bean-counters count ~~beans~~ pills, not mg's. Try to get a change of your prescription for 100 mg pills. These you can split in half (or quarters) for a lower dose and a corresponding longer supply.