7 Ways to Get More Triptans Each Month
Now that you know why triptans are rationed and the rationale behind it, let’s get to what you really want to know—is there a way to increase how many triptans you get each month? The answer is yes, as long as it’s the insurance company that’s limiting your triptans, not your doctor. (If your doctor limits you to a certain number of triptans each month out of concern for medication overuse headache, these strategies don't apply.)
1. Appeal to your insurance company. Contact your insurance company to find out the process for increasing the number of meds you get each month. Prepare everything you need and give it to your doctor (I type it up and print it out). You’re best off asking for a reasonable increase, like to 12 a month, than higher than that. My doctor requested 30 a month; my insurance company respond by decreasing from nine to eight. An insurance rep told me it was because my doctor asked for an unbelievable (to them) quantity.
2. Use regular pills instead of nasal sprays, injections or dissolving tablets. These “fancy” forms cost more for the insurance companies, so they are often restricted even more than pills. If you can get relief with oral triptans* and more than one kind of triptan is effective for you, find out if you would get a higher quantity in a prescription for Imitrex (sumatriptan) pills, for example, rather than injections. (*Triptans are offered in so many different delivery methods because the pills don’t work for everyone. Some people can’t keep pills down. The other problem is that your digestion slows down during a migraine, which prevents some people’s bodies from processing pills quickly enough to be effective.)
3. Ask your doctor to write prescriptions for two different triptans. Some insurance companies limit the number of each prescription, but not the number prescribed within a class of drug. You'll probably have better luck if you use two generics.
4. Find out if you insurance will cover the same drug in two different delivery methods. This seems less common than getting coverage for two different triptans, but some insurance companies will fill a prescription for sumatriptan tablets and another for sumatriptan injections in the same month. (This works for other triptans, too. Sumatriptan is the most common, so I used it as the example.)
5. Ask your doctor if your pills can be split. Depending on the triptan you use, the dose you need, and your other health needs, splitting pills might be an option. Not all pills can be split safely and some people increase their risks by splitting pills! Do not try this without first discussing it with your doctor (and possibly your pharmacist, too).
6. Ask your insurance company if you can get more pills if you pay a higher copay. If you get nine pills a month for a $10 copay, ask if you can get two prescriptions (totaling 18 pills) and pay $20 in copays.
7. Use a drug discount card and pay cash for additional triptans. Paying cash doesn't increase insurance coverage, of course, but does increase the number of pills you get each month. Instead of buying nine, you can supplement with just the number you need each month. For sumatriptan, you'd pay $1.60 per pill using a drug discount card, like GoodRx.
(I recognize that extra copays or paying for additional pills out-of-pocket is cost-prohibitive for many patients. I mention the possibilities for those who can afford the extra cost and haven't considered these options.)
Have you shared your migraine story with us yet?