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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.)

 

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • maxgordon
    3 years ago

    My insurance company just denied my injectable sumatriptan (after three years of covering it with no problem). The pill form does not work for me, so I am forming my appeal. Do you have any specific advice that could help? We could email off-board if you prefer. Thanks.

  • 1ys5kk0
    4 years ago

    I currently have United Healthcare which limits me to 4 pills monthly. My dr will prescribe up to 18. I used to have to buy them from Canada before they became generic in the U.S. (Maxalt). Now I ourchase them from Costco without having to use my insurance. They cost between $25 and $75 a month depending on the price they are able to bring them in for. When I had no insurance a few years ago, I got them thru Merck for free, but as soon as I was covered. That went out the window. At Costco I pay the cash price and I don’t use my insurance as it would require me to pay $40 for 4 pills.mway more than they cost if I pay cash for the whole $18. Scam!

  • lerickson82
    4 years ago

    Thankfully, I am on two different prescription plans, because the drug benefit from the place I work is terrible. As Margo wrote, my United Healthcare drug plan will give me 4 at a time. I’d still get 8 in a month (though my doc prescribed 9), but only 4 every two weeks. Might not seem like a big deal, but it increases the fear of running out greatly if I have a bad week. With my husband’s drug plan I can get 8 at once. I am now trying Treximet, but my United Healthcare drug plan just refused to cover it (not a generic). My other drug plan covered it for $25, which is fine. I’m angry though because my co-workers suffer with migraines too, and they can’t get enough meds through our plan.

  • MargoW
    4 years ago

    I’ve heard that about Costco and Zolpidem as well. I’m so glad you can get your Maxalt this way. My sister is having issues getting her Relpax so maybe there is a generic option.

  • mlkester
    4 years ago

    I’d like to thank you for the information about the GoodRx drug card. I have been dealing with chronic migraines for 30 years and like most everyone else, my insurance limited me to 9 pills a month which has never been enough. I have tried multiple preventives that did not work and have worked with one of the best migraine clinics in the nation to no real effect. However, sumatriptan always works for me as long as I catch it soon enough and with no significant side effects. Unfortunately, the 9 pill limit left me with few alternatives all these years (or so I thought) so I have been buying additional pills over the internet which has been increasingly hard to find legitimate and legal ones and then be able to stay with that one pharmacy as more and more go out of business. Even then it was still extremely expensive. Btw, I discussed all of this with my doctor who subscribed me more pills (over my normal 9 pill prescription) to use these pharmacies legitimately (I tried to stay away from ones that didn’t require a prescription). But I did it because I thought it was my only option. Imagine my surprise at your suggestion of the GoodRx drug card which, up until I read it, I had no idea existed as I have always had drug prescription coverage so it was never even on my radar. 1 week later and a fresh prescription from my doctor and I just got 21 pills filled at my local pharmacy without insurance using the GoodRx card for $26!!!! That is at or less than what I pay with my insurance and easily 4 times cheaper than what I have been able to buy it online. I really thought it was too good to be true but there it was. My doctor actually gave me three different drug discount cards to try and my pharmacist said the GoodRx card is usually the best and proceeded to fill it. I can’t tell you how happy I am right now and just wanted to say thank you! You just made my year!.

  • 20qjsi2
    4 years ago

    Midrange helped me control my migraines. As soon as I felt that sharp pain in my left or right eye and took this medication I was saved between 30 in to an hour. They stopped making it without explanation to me at least and I have been lost in eternal pain. Not even a triptan relieves my pain. I have to some how or not make it to the emergency have to injected by Torodol. It cost $100 for emergency services and my Midrin cost $20 that they no longer supply.

  • MargoW
    4 years ago

    My 19 year old daughter gets daily migraines because of a Chiari malformation. Because of her age, I was greatly concerned with her abortive options. I mentioned that Midrin worked well for me at that age and I was sorry that it was no longer on the market. To my surprise, my neurologist said that it was still available and my daughter takes it virtually every day. She did confirm that Midrin hadn’t been available for a while but that it’s definitely back.

  • SJD
    4 years ago

    I am a licensed health insurance agent and part of my job is helping people get the meds they need when the insurance company say there is a limit. I have found that many customer service reps for insurance companies aren’t knowledgeable and they just tell you there is nothing you can to to get more medications. They are often trained with only the very basic company rules and are not aware exceptions can be made. Often doctor’s can override an insurance company’s rule about how many of a certain medication you can get. You will need to ask the insurance for the correct authorization form the doctor needs to fill out. It might be a regular prior authorization form or it may be one stating the doctor has tried other medications but they did not work therefore he/she wants you to have a certain amount of the medication. Don’t just accept the customer service agent’s word for it that you can’t have more pills. You can often print out the correct prior authorization from your insurance company’s website and give to your doctor.

    I do this every day for customers.

  • MargoW
    4 years ago

    Thank you for what you do and for understanding that 9 sumatripan injections over 3 months doesn’t work for someone who has migraines 25 or more days a month. I have prescriptions for four different abortives to try and avoid medication overuse headaches but also just to survive.

  • SJD
    4 years ago

    I don’t think Canadian pharmacies have the same restrictions on the number of pills you can get at one time for triptans. I get quite a few but I can’t quite remember. Definitely more than 20 or 30. I work in the health insurance industry here in the USA and I know how many hoops they make you jump through. I hate it.

  • Nicci
    4 years ago

    Highly recommend looking into the recommendations about Costco and the Canadian mail order pharmacies written below.

  • SJD
    4 years ago

    Do be careful with Canadian Mail order phamacies. Some are internet scams just to get your personal info or credit card number. I have personally used Pharmstore.com for over 6 years and never had any problem.

  • mollyb612
    4 years ago

    I have United Healthcare, which seems to be the worst company for prescription coverage. United allows me 4 – yes 4 – Sumatriptan at a time, with a $15 copay. I can refill more than once per month, but then I’m paying the copay each time. Even if I go through their mail-order pharmacy program, I only get 12 pills, which is supposedly a 3 month supply. I appealed for a higher limit before, and they denied it. My doctor wrote the prescription for 12/month. Thank you for the recommendations for Costco and GoodRx – I will definitely check them out.

  • shine4him
    4 years ago

    Another tip regarding #5… you can ask your pharmacy for a different generic that is easier to split. My pharmacy switched to this generic sumitriptan that was very tiny, and I complained and asked to go back to the one they had supplied previously (I did frame my complaint more around “it doesn’t work as well” rather than the size, but both were true). They put a note in my file to always fill mine with the other generic (in this case, it was the Dr Reddy brand). Those horse pills can be broken easily by hand, so I don’t need to carry a pill splitter with me or worry about uneven breaking like the smaller pills are prone to do.

    Now here’s just hoping my new insurance will allow for higher limits! My last insurance capped it at four. *sigh*

  • SJD
    4 years ago

    Relpax is much more expensive than Naratriptan but Naratriptan works just as well.

  • SJD
    4 years ago

    http://www.relpax.com still has the card you can use once a month for a huge discount on Relpax. You can’t use it if you are on Medicare, Medicaid or other government prescription assistance.

  • Misty-mckinnon
    4 years ago

    Naratriptan doesn’t work for me at all, but Relpax does.

  • SJD
    4 years ago

    I order my triptan’s from a Canadian pharmacy called pharmsource.com. I pay a fraction of the price for them and don’t run them through my insurance at all. It’s cheaper than through my insurance company. I have them mailed right to my door. I just have my doctor send the prescription to them. They have an 800 number for excellent customer service reps take care of every thing for you. It’s good to know about Costco too. I should compare what I’m paying to Costco.

  • SJD
    4 years ago

    I meant to type pharmstore.com, not pharmsource.com.

  • Nicci
    4 years ago

    An 8th option… ask your doctor to write a script for your regular pharmacy and a second one to take to Costco… the Costco pharmacy does NOT require you to have a Costco membership and their prices for generics are even better than Canada. I’m thankful there’s a pretty affordable way to get them out-of-pocket. I think it’s about $3 per Sumatripan pill.

  • Jill M.
    4 years ago

    Thank you for this article, Kerrie! A lot of great suggestions to consider. I don’t usually have a problem with not having enough meds, but great to know there are options if I ever have this issue.

  • Luna
    4 years ago

    I found this article very interesting.
    “A small number of my patients take triptan medications daily. Many doctors, including neurologists and headache specialists think that taking these drugs daily makes headaches worse, resulting in rebound, or medication overuse headaches (MOH). However, there is no evidence to support this view. Sumatriptan (Imitrex, Treximet), rizatriptan (Maxalt), zolmitriptan (Zomig), naratriptan (Amerge), eletriptan (Relpax), almotriptan (Axert), and frovatriptan (Frova) have revolutionized the treatment of migraines. I started my career in 1986, five years before the introduction of sumatriptan when treatment options were limited to ergots with and without caffeine (Cafergot), barbiturates with caffeine and acetaminophen (Fioricet), and narcotic or opioid drugs (codeine, Vicodin, Percocet). These drugs were not only ineffective for many migraine sufferers, but they also made headaches worse. Dr. Richard Lipton and his colleagues followed over 8,000 patients with migraine headaches for one year. Results of their study showed that taking barbiturates (Fioricet, Fiorinal) and narcotic pain killers increased the risk of migraines become more frequent and even daily and resulting in chronic migraines. We know from many other studies that withdrawal from caffeine and narcotics can result in headaches. However, taking triptans and non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin (Migralex), naproxen (Aleve), ibuprofen (Advil, Motrin) does not lead to worsening of headaches. ” Dr. Alexander Mauskop
    http://www.nyheadache.com/blog/daily-use-of-triptans/comment-page-2/#comment-289614

  • eae4oi
    4 years ago

    I found that article fascinating. I used it years ago in an appeal letter.

  • SJD
    4 years ago

    Ergots never helped me anyway. I got better results from my primary care doc and Imatrex back in the day, but now the triptans help me the most. I had no help at all from the Neurologist I went to.

  • Teresa
    4 years ago

    I have used the the Good RX card several times when I have had really bad months. Through my insurance in one month, I can get one prescription of 9 100 mg sumatriptan pills which cut in half to make 18 pills. I can also get two prescriptions of 4 sumatriptan injections. So in all I end up with 18 pills and 8 injections. If I am having a really bad month, sometimes this is not even enough. I have used the GoodRX card to buy another prescription of the pills for around $20 at Walmart. (I pay $5 with insurance.) I don’t do this often because I am aware of the dangers of the MOH, but when I have a round of Status Migranous, I will throw all caution to the wind, forget about MOH, and keep taking more to try and make myself feel better. I have used 6 injections and 10 halves of pills in a 4 day period before during one of those bouts.

  • SJD
    4 years ago

    I’ll have to google GoodRx since I’ve never heard of it. Many drug manufactures offer coupons to help pay for their meds. I used to get Relpax that way.

  • Teresa
    4 years ago

    SJD,
    I have actually traveled all over the US with a job I used to have, and even though my migraines were not as bad then as now, it did not seem to matter where I was, I still had migraines just as bad. I was in each place for at least 2 months, so I had plenty of opportunities for migraines, lol. I was not in Denver, but I was in Colorado Springs for 4 months, and I was in Phoenix for 3 months. The only difference I noticed is that the heat in Phoenix seemed to make things worse because I was there for the whole summer. I live in Georgia now, which is where I have lived most of my life, when I was not traveling for work.

  • eae4oi
    4 years ago

    I love goodRX! It saves me about $200 a month!

  • SJD
    4 years ago

    Teresa this my sound weird but I had really bad migraines and non-migraine headaches all the time when I lived in Denver. I have recently moved to Phoenix and have reduced my migraines by 90 percent. When I do have a migraine it’s not nearly as severe as they were in Denver. I think it’s the high altitude of Denver which creates pressure in the atmosphere. Just a thought…

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