The Cost of Wellness - Affording the CGRPs

By Holly Harding

4 min read

Those who are experiencing wellness for the first time in years because of the CGRP medications may be feeling as if they are living on borrowed time. This is due to the fact that several of the drug companies responsible for these treatments have provided introductory offers to encourage patients to give their medications a spin. The question is, what happens after these offers expire and the medications become financially impractical for most patients?

What have people been able to do because CGRPs?

These drugs have been a life-changer for many. Some have gone from disabled to abled due to these medications. Others simply (and wondrously) have felt a slight but marked improvement in their pain patterns for the first time in years. Some report that they are experiencing moments of enjoying life again. Parents are showing up to their kids sporting events. People are actually following through on plans made with friends rather than constantly canceling out. People in the workforce might even start building back their sick and vacation banks at their jobs. On many fronts, in many cases, many migraineurs are knitting their lives back together and feeling a sense of joy, energy, and independence not experienced in recent memory.

What happens when the programs run out?

So, when these free access programs run out, and the bills hit, the question follows: What are you willing to pay for your freedom; for your quality of life? If we are either uninsured, or underinsured, we may be expected to pay anywhere from $300 to $3000 a month to maintain the CGRP treatments. How many people can afford or sustain such a cost?

Are CGRPs worth the temporary migraine relief?

These treatments have the power to remind us of our capabilities; of what a full life feels like. Especially for those of us who have lived with chronic migraine for many years, perhaps forgetting what it was like to feel pain-free for even an hour. If we then have to return to the endless days of slogging through severe pain and related neurological symptoms that make our brains foggy and sleepy; will it help to have known that return to wellness if it was only a brief respite? Experiencing goodness and health and to be reminded that we are capable of such a thing is perhaps sustaining. And maybe just having lived it temporarily may serve to fuel us as we dive back into the challenges of life with chronic pain all over again. The break from pain may serve to provide some reserves in our tank so that we can continue on.

Or are they a cruel joke?

For others - having tasted the kool-aid of wellness just to have it whisked away - may find it just too cruel of a joke. I mean, really. How can there be a treatment that is so effective, for so many, that is put just out of reach in the name of profit. It’s a financial windfall for the greedy few in the drug industry who are playing games for money - but it’s a life changer for those living with a demanding complex neurological disease.

It truly is infuriating and unjust. I’m sure for some, they may have wished to have gone along not having known that there was something so effective if they wouldn’t have been able to afford it in the long run. It’s just too heartbreaking. Here’s a carrot, Mr. Rabbit. Right out of your reach. It’s a crazy-making thought. And migraine is infuriating enough as it is.

This or That

Does insurance or the cost of medications get in the way of your migraine treatment?

Is it better to have loved and lost?

"Tis better to have loved and lost than never to have loved at all." That saying, by Alfred Lord Tennyson, holds a lot of meaning in general and applies to those of us with migraine, too. Is it better to have experienced wellness and have it taken away than to have never known it was in reach in the first place? For some, the reprieve we experience from relentless severe pain is so tremendous - so priceless - that it is life-giving. Life-affirming. These treatments are relatively new, so the landscape may shift (with the introduction of new competitors, for instance) to put them in financial reach for the masses soon. But in the meantime, perhaps it is better to have tasted wellness, even if for a brief window of time, than to never have known its existence.

What can we do?

Perhaps knowing that effective treatments for migraine finally exist but are out of the financial reach of many will lead to a collective raising of voices to right this wrong, sooner than later. Calls can be made to insurers, drug manufacturers, and your state representative to voice your thoughts on this matter.

Have you tried the CGRPs? Are they working for you? Are you concerned about what the future will hold once the coupons run out or are you already running into problems with affording the treatments?

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.

Join the conversation

Please read our rules before commenting.

tortoisegirl Member
I avoid meds/treatments not available through my insurance, as for me, worst case scenario would be knowing something significantly helps (due to a sample, coupon, etc), but I couldn't afford it. Its been a huge pain trying to get my doctor's office to do a Prior Authorization for CGRPs for me as they just want to sign patients up for the free programs and such...it must be easier for them. So, I've only tried Aimovig so far, without relief. So happy that so many folks are finding relief though.
1. joyrobbedbypain Member
 Holly, You are correct that I am covered by Part D in Medicare. It isn't logical to me that the savings card for Emgality doesn't work if you are insured through a government sponsored insurance. Individuals that I know that have Medicare do not have the income to make specialized medications, like Emgality, affordable. I appreciate the support, articles and conversation found here. I will keep post updates when/if I learn anything new.
2. Alene L. Brennan, RYT Moderator & Contributor
 That makes sense. It does feel like a bit of a tease to find something that works but you can't ultimately continue because of costs. In the meantime, hope that you've been able to find some relief options for you. - Alene, moderator
dinamay Member
I know what you mean about our medical system being infuriating and the cruel joke of knowing something that helps but it’s out of reach. I’m now using Emgality with some real improvement. But in December I become eligible for Medicare and that will presumably be the end of my Emgality. For now. It’ll be a bummer to go back to spending days at a time in bed. But I remember years ago when Imitrex first came out. It was fantastic to have something that eased the pain. But the injection made me feel worse before it made things better. Later I could get pills instead of the infection. At first that was a mixed blessing because it was easier on my system but tough on the wallet — $35 per pill when that $35 was my weekly grocery bill. Time passed and an affordable generic came out. But the med didn’t work for me anymore. On to the next med to try! I will miss Emgality for sure. But for now I’m making good memories that will help tide me over till a generic is available. Or the next breakthrough in treatment. Or a change in our medical system. We can always hope
1. Holly Harding Moderator & Contributor
 <inline-mention username="Elora" user-id="9740259"/> Very helpful, real-world information! Thank you for sharing this with us. I hadn't heard that Topamax caused bone loss and have been taking it for nearly 20 years! yikes! At any rate- thank you for that and the rest of the information. You are so right that working with a representative each year to revisit meds and doctors to ensure you have the best plan is a great idea. Warmly - Holly (team member) 
2. Elora Member
 <inline-mention username="Holly Harding" user-id="3755969"/> Thank you!
onehsancare Member
I'm on Aimovig, through the patient assistance plan, which is almost at the end. My insurance is saying that they won't cover it in the future because I am also on Botox and there is no evidence that the two are compatible. (Beyond my terrific response, I guess!) So I wrote to both Amgen and the lead researcher on Aimovig telling them that I am by no means the only patient with this dilemma, and asking why there is no ongoing clinical trial about the efficacy and safety about the concomitant use of Aimovig and onabotulinumtoxinA, to allow patients to get approval with third-party payers. I got no response from the researcher and Amgen said that it was "aware of the challenge and is actively considering approaches to generating new information that may be beneficial to securing access for Aimovig patients. [My] suggestion and rationale for the requested study is appreciated and has been relayed to the appropriate Amgen staff." Given how long it takes to get such a study up and going, let alone to the results stage, I'll be on Medicare before anything happens. I wonder if switching to Emgality for a free year, and then trying Ajovy for a free year would solve the problem, or if my insurance would stop covering Botox . . . .
1. ledespard Member
 <inline-mention username="onehsancare" user-id="3850970"/> I think the idea of switching when the year is up. I had to change to Ajovy because Aimovig is no longer on my insurance formulary. It is not quite as effective, but still a gamechanger. I hope my insurance continues to cover it for a long time. Without the discount, my copay is decent. It would be helpful to millions to have Medicare cover it, and the companies offer the discount to Medicare patients. I am only 2 years away from Medicare. Even though my employer for my pension includes Medicare advantage type plan, it worries me about the increase in cost to me.
2. Holly Harding Moderator & Contributor
 <inline-mention username="ledespard" user-id="3802310"/> It's wonderful that you were willing to be flexible to try another CGRP and are open to using it even though it is slightly less effective. I think your openness and flexibility will serve you well when you enter the land of Medicare. The best guidance I can give you is to gain advice and guidance from two Medicare specialists before you choose a plan. It can get confusing and things change (as you've already experienced with your current plan) so the best you can do is be prepared and choose a plan that covers one of the CGRPs at the best possible rate. My Medicare Advantage plan covers emgality for a little more than $100/month- but that's much better than $800/month! I'm constantly worried they will stop coverage as I've tried the cgrps and they don't work for me. So, again, do your homework when the time comes and each year when it's time to re-up, do that homework again to ensure you are on the right plan for you. All we can do on top that, is to hope that Medicare finally chooses to cover these key treatments for the millions of Americans who have migraine. Thanks for chiming in and please let us know if you have any questions. We are so glad you're a part of our community. Warmly, Holly (migraine.com team).
lindaann Member
I feel like this is going to be a huge issue. I spoke to the pharmacy providing my "free" Aimovig and they said that insurance companies are not going to cover it and it will be 600 a shot! I have had a reduction of 50% with this drug but apparently our lives don't matter! I think we should advocate!!!!
1. Holly Harding Moderator & Contributor
 <inline-mention user-id="3806021" username="lindaann"/> - I agree that advocating would be in order on this front. I'm going to ask around and see what this would look like. I hope you'll do the same and let's check back and see how we can hopefully move things forward. Thanks for reaching out! - Holly (migraine.com team).
2. mrsmimoo Member
 As more of these shots come on the market I guess prices should go down, but if a cartel sets up you will have to fight for prices to be reasonable.
meredithmarcus Member
Do I think there is a financial incentive to dangling a treatment that could actually make a difference in people's quality of life??? I experience firsthand the financial incentive being an obvious collaboration at every level of the "medical" industry on a regular, ongoing basis. Since insurance started covering "botox for chronic migraine" I have been getting the 31 injections like clockwork every 90 days for a few years now. It has been the only thing to make a difference in my quality of life with minimal side effects. Plz note this is not an endorsement, just explaining my experience. I tried it for chronic migraines when it was initially approved but couldn't afford it out of pocket (around 2006), so this has been a dream come true. Anyway, I also have to go in for follow-ups in between treatments or my neuro will not authorize the treatment, even though my entire treatment regimen has not changed and it has all been with her. So that's an appt every 45 days. When the first CGRP arrived I was told it was promising but monthly (so big deal at this point, right?), that it "may" be covered by insurance but not for sure, that attempting coverage for CGRP could risk losing my other treatment coverage altogether (a pretty penny), and kicker...we don't know if it would even work! So I have stuck with what has been working best so far. I sometimes miss my follow-ups, ironically usually due to a migraine, and have to rationalize with the dr to get out of the missed appt fee. So, with all these mandatory appointments, even when my migraines are less, I am still overwhelmed with constant Dr. visits and stuck in the loop of pain, taking off work=more pain and a pain in the a** to get something that actually helps with my pain. Doesn't sound like anything out of the ordinary to me these days!
1. Holly Harding Moderator & Contributor
 <inline-mention user-id="3828962" username="meredithmarcus"/> - oh my, you raise SO many good and important points! Managing migraine can end up feeling like a full time job. The cost is significant- both financially and in terms of the commitment of time. I'm glad you raised Botox as an example - because it initially was experimental and very expensive and difficult to get covered by insurance for migraine. I was one of the very first patients to try it for migraine (back in 2002) and it's come such a long way to the point that there is now a savings program that reimburses nearly all costs related to the treatment. However, now the interplay between Botox and the CGRP treatment is in question. There actually have not been studies to show the two treatments are contraindicated, indeed, there is some data that shows the treatments use the same mechanism/focus on the same thing - but nothing shows they aren't good to use together. Still, to be cautious, the current guideline is that the two treatments shouldn't be used in concert. Many of us have learned the hard way that being taken off Botox is a bad idea and that indeed it does help to take both of these treatments together. To me, this is a reminder of how early we are in the life of this treatment- this is like the 2002 of Botox- when it was difficult to find a doctor who even knew how to administer the drug for migraine. Now, 18 years later, it's one of the primary modes of accepted treatment for chronic migraine. So, yes- nothing really new here in terms of these dynamics/challenges. But hopefully the process of getting the CGRPs covered won't take quite as long as it did for Botox. And hopefully, our treatment plans will eventually be streamlined so that this part of our lives won't be so time-consuming!
usedtogarden Member
I have been on botox/aimovig (plus other preventatives) to control chronic intractable migraine for just over a year. What a change it's been! Before starting aimovig, my migraines went on for months. I can't take triptans, and because of rebound headache, taking painkillers seems to only extend/worsen my migraines. We spend a lot of time in the infusion center when a migraine strikes. Except since aimovig, I've been having so many more good days. Yes, there are still migraines. But to have all those lovely hours, those functional days... I can't even describe what a gift it's been this past year to be doing just a little bit better. And it's cruel that because of greedy insurance they want me to go back to lying curled in bed every day again.
1. Elora Member
 <inline-mention username="Holly Harding" user-id="3755969"/> Never to the ER, but once to a walk-in clinic, and I asked them to do what they did on the day after my emergency appendectomy years before when I developed one of my "deathly" intractable migraines-terrible pain with the beginnings of intractable nausea-thanks to the Delotid (sp?), probably. It was a dangerous "cocktail" of ibuprofen, Reglan and Zophran in my veins, which alleviated the migraine attack such that I was not only better, but was well enough to eat (and thank goodness their egg salad sandwich did not have relish in it!), which was the main criterion by which I could be discharged from hospital. I wonder if that "cocktail" is still used.
2. Holly Harding Moderator & Contributor
 <inline-mention username="Elora" user-id="9740259"/> Ah- fascinating. Thank you for sharing about this cocktail. If you look up migraine ER cocktail online you will see a general guideline but there is a lot of play under each category. I suppose it's up to each hospital/ chief of medicine to determine their actual course of action. I'm glad it worked for you. Dilaudid can definitely induce nausea and is frequently given in concert with zofran or other anti-nausea meds due to this fact. Thanks again for sharing! Warmly - Holly (team member)
mrsmimoo Member
Over here in England the health authority called NICE (not nice) have decided not to fund Aimovig after making a mess of the clinical tests. Scotland get Aimovig, Europe gets Aimovig, England does not. I will have to fund it myself. I am not a rich person and it will cost the equivalent of US 9-10k a year if I want to try it. It is 7nclear at this point if Ajovy or Emgality are available yet. I am sick of Topamax making me sick although it reduces me from 30 migraine events a month to 10. We don't have insurance here really and as migraine is a pre existing condition I'd not be getting any treatment for it!
1. Holly Harding Moderator & Contributor
 Hi <inline-mention user-id="3808984" username="mrsmimoo"/> - So unfortunate that Aimovig has been deemed uncoverable by the "authorities" in England. Many people have reported side effects related to Topamax- brain fog, aphasia, hair and weight loss, to name a few. For some people, some of these side effects quiet after months on the medication. Have you been taking it for long? I think many of us hope that the new CGRP treatments will become more widely available and accessible as soon as possible - and with time, they likely will- the question is how quickly that will occur. Certainly hard to be patient with so much at stake. Hope you'll stay in touch as to how things develop in England. Thinking of you.
2. mrsmimoo Member
 thank you so much. I have just had my first Botox treatment - they say it won't help until I have had two or three.I am praying it will work; we are doing the maths to see if we can afford Aimovig ourselves. But as I sad above, it's very expensive without insurance or any health care provision. This condition affects so many of us, and it's debilitating. Time for change.
mrsmimoo Member
Thank you for your support! This site has been really helpful and inspiring and I have used it with my Neuro nurse and consultant.
1. Holly Harding Moderator & Contributor
 So glad to hear that- we are here for you anytime. I've had botox injections for 16 years now- and I hope you'll feel something before three months. Please do let us know how you're doing. Paying out of pocket for the CGRPs is asking so much (literally). I would encourage you to follow up to see what will happen with Emgality and Ajovy as - if those end up getting funded- they would certainly be worth trying. It seems random that one type (Aimovig, Ajovy or Emgality) works great for some people, and not at all for others and vice versa. I'm not sure you'd need to fund a whole year to find out which one is best for you. I knew after just two months that Aimovig, for instance, was not a good fit for me. It only took one injection of Emgality to experience a much better response. Hopefully while you're experimenting to find the best one for you, there will be work happening to get these therapies funded in England! Thinking of you and again- please do stay in touch.
bookseller Member
I found some good relief w/ Aimovig, but the Emgality is fantastic so far! Dangling this 24 ct gold, chocolate covered carrot held by a buff fireman just out of reach is beyond cruel. Speaking for myself, it would be incredibly difficult to go back to all migraine, all the time. You can bet I’ll call my insurer, the drug manufacturer, and my representative if necessary. We’re so used to being beaten down by these migraines, let’s stand up and fight for these amazing meds.
1. Elora Member
 <inline-mention username="Nancy Harris Bonk" user-id="3845796"/> Hi Nancy, It was easy to FOLLOW, but boy, I am still occasionally missing what I CANNOT eat! The book Heal Your Headache. . . has excellent information and even recipies contributed by the author's wife! But ACCEPTANCE is key to all of this, and I have found that my cravings for chocolate have greatly diminished over the two decades since I've been on this diet. There were too many times when the consequences of eating chocolate were so severe that I just had to face it and call it quits. There are good recipies out there for those on the HYH diet. One I don't have is "The Dizzy Cook Cookbook" (I guess the author (whose name I can't recall now) gets vestibular migraine) and two by Stephanie Weaver: The Migraine Relief Plan" and the "Migraine Cookbook". She's a nutritionist and herself one who lives with migraine. The Migraine Relief Plan has loads of information about nutrition plus recipies, and the other, the cookbook, includes great pictures. She does include legumes (beans), which I skip, because unfortunately, if I eat enough, they trigger migraine for me. But I use chickpeas instead. It's fun to cook her dishes, as she includes lots of spices (all "allowed&quot😉, and it takes me away from that "deer in the headlights" place when it comes to planning meals, and having fun doing so.
2. Nancy Harris Bonk Moderator
 <inline-mention username="Elora" user-id="9740259"/> Thank you for the update! Good to hear you've only had one migraine since the dose change. Fingers crossed things continue to go smoothly. We've heard from many who benefit from HYH. Then there are people with migraine who don't have any food triggers. Migraine is such a complex disease! Too much gluten, nitrates and MSG will undoubtedly trigger a nasty attack for me. Alicia Wolf, The Dizzy Cook has great recipes I've made over the years. And you're correct - she lives with vestibular migraine. I look forward to hearing your next update, Nancy Harris Bonk, Patient Leader/Moderator (team member)
fbussotti Member
I would love to have an opportunity to try these medications. Unfortunately these drugs are not available With the low cost or free coupons if you are on Medicare. If you qualify for the super low income Medicare help or Medicaid you can get them next to free, but if you have any assets or income you are out of luck. Does that seem backwards to anyone else? Anyway, so it’s daily Sumatriptan for me.. 12 years 365 days a year... and counting. Irritating, but I am grateful for it. It was a nightmare before triptans
1. ambelena Member
 I hope you can find a way to get one of these meds. I have private ins through my husband, and Medicare from my SSI Disability, and I lost my $5 scripts around January and have now been paying $75/mo for it. It leaves me with nothing, but to have some relief is so worth it! Good luck and feel well
2. Holly Harding Moderator & Contributor
 Hi ambelena- Thanks for checking in. Glad to hear you are experiencing relief from this medication though sorry you're having to pay an extra $70/month for it. Wouldn't it be wonderful if we could have access to these life-changing treatments without the life-challenging pricetag? - Holly (migraine.com team).
screek Member
I started Emgality in December and it has definitely been a lifesaver. I feel like I have gotten my life back. Working a a nurse manager was increasing my migraines to where I was waking up almost daily- usually pain at the base of my head and neck that radiated to mostly the left side of my head. It was drastically affecting my work. Coworkers hate hearing that you have to take the day off or cut it short because of migraine, so it affected not only me but everyone else who had to pick up the ball for me. Lost productivity should be a valid reason to get sponsorship and support from companies to work with insurance carriers to assist their employees pay for any treatment that will ultimately save thousands in sick pay, lost productivity and turnover that issues like migraines present. In the meantime do your homework. Insurance companies want you to try “gold standard” medications first. However if you have a very good reason to not try those medications first ( I refuse to take Topamax because I can’t afford to deal with the psychotropic effects at work) then have your doctor put those rational in the prior authorization. Your carrier may still approve the CGRP inhibitor injection if you have a reasonable explanation. Also take advantage of free samples if your doctor has them available. The Emgality program ends December of 2020 but maybe that will buy enough time for us to advocate our needs to pharmaceuticals and insurance carriers to offer lower co pays. And as more CGRP inhibitors are introduced to the market the supply/demand effects will push cost in favor of the consumer.
1. MelanieM Community Admin
 screek, I am so glad to hear that Emgality is making such a difference for you. Thanks for sharing all that you have learned with us about the programs available! I am also on Emgality- previously I was on Aimovig, and after the first year was up, I was able to renew the program for another year- I hope that will be the case with Emgality too! Fingers crossed! ~Melanie Merritt (Migraine.com team member)
my-head-hurts-2 Member
FYI, here in California we have Anthem Blue cross from my husbands work, part of this I just found out about maybe 6 months ago, part of our Rx policy is express scripts. Instead of paying over $500 a dose, I pay $40 for a 3 month supply, if you can get it, it is worth it
1. Holly Harding Moderator & Contributor
 my head hurts- Thank you so much for sharing this unique combination of solutions that results in an affordable prescription. That DOES sound worth it. Which CGRP are you taking? - Holly (migraine.com team).
tigger2 Member
I am turning 65 in March. After reading some of these I've started wondering if Medicare will cover my Ajovy. I'm still trying to get Cambia (powder) because it breaks up some of the migraines I do get, even with the Ajovy. How does Medicare work when you have savings in the bank? I've worked since I was 15 to build up a bank account backup.
1. Holly Harding Moderator & Contributor
 Hi Tigger2- Great question regarding CGRPs and Medicare- and really, just how Medicare works in general. We have a number of articles for you to skim on the topic here: <a href='https://migraine.com/?s=medicare' target='_blank'>https://migraine.com/?s=medicare</a> And this one is a good primer on the topic: <a href='https://migraine.com/blog/adjusting-to-medicare' target='_blank'>https://migraine.com/blog/adjusting-to-medicare/</a> Here's a Q&A post specifically on Medicare and Ajovy: <a href='https://migraine.com/q-and-a/ajovy-medicare' target='_blank'>https://migraine.com/q-and-a/ajovy-medicare/</a> Hope these are helpful for you. Thanks for chiming in and please stay in touch! Warmly, Holly (migraine.com team).
2. xersiz88 Member
 Medicare does not cover drugs. You must pay for separate drug coverage called Part d plans that you select from many offerings, and they might cover this but check with your agent before deciding which one you want to subscribe to.
Debbie1530 Member
For those on Medicare, consider trying Vyepti. It's administered as an infusion -- in an IV rather than an injection. Since you need to go to a clinic to receive treatment, it is covered under Part B rather than Part D. This also means the cost will NOT be considered in determining if you are in the donut hole for drug coverage. I switched over from Ajovy. A few more migraines after this first treatment, but next time I'll get the higher dosage, so I'm hopeful it will work just as well.
1. Cheryl Picerno Moderator
 @Debbie1530 that's a great tip for people on Medicare. Thanks for sharing it. I know how much of a struggle many people experience trying to cover all their treatment bases on Medicare. I hope you continue to have success with Vyepti! Warmly, Cheryl <a href='https://migraine.com' target='_blank'>migraine.com</a> team
dinamay Member
For me, the you-know-what already hit the fan. I got to try Emgality for a couple of months and they were WONDERFUL months. Then I turned 65 and started on Medicare. My insurance ended its full coverage at that point and turned into a much more measly Medigap policy. So my affordable copay turned into a very unaffordable several hundred dollar price tag. Goodbye Emgality. Hello migraine. But that’s life on Medicare. Generics are what’s covered at a price I can afford. If I were wealthy, I could pay out-of-pocket and continue getting Emgality. But then, if I were wealthy, I wouldn’t need health insurance or Medicare, would I? At least my daughter, who inherited my migraines, won’t have to put up with this nonsense. She has moved to Germany. They have a much better health care system. Now if I could just say the same for my son. He doesn’t have migraines but he inherited the other family horror, known as asthma. That’s my other ghastly expense that Medicare doesn’t adequately cover. Ya know, it’s a royal being old! But it beats the alternative.
1. Nancy Harris Bonk Moderator
 <inline-mention username="dinamay" user-id="3907903"/> I hear you!! Whoever said these are the "golden years" were lying!!! On a more serious note, I've heard from a few people on Medicare that after the appeal process are able to get these newer treatment covered. Maybe a route to try? Let me know what you think! Nancy Harris Bonk, Patient Leader/Moderator Migrai
2. Holly Harding Moderator & Contributor
 <inline-mention username="dinamay" user-id="3907903"/> Hi there- I might have already shared this idea with you, I can't recall- and sorry if this is a repeat. I am also on medicare and was able to find a plan, through a ridiculous amount of looking and the help of a medicare specialist- for a plan that covers emgality (also a game changer for me). it's still expensive, $150 a month - but less than the $800 it could be-- the dumb monthly premium for medicare is ridiculous to me and no savings from private insurance and I think is high because I'm on an advantage plan (because it covers emgality). At any rate- I bring all this up in case you could find a medicare specialist to walk you through other options and plans that could perhaps cover emgality. Let me know if that works for you. Thinking of you. Warmly, Holly (migraine.com team).
CommunityMember8514709 Member
Unfortunately, even with what’s considered “good insurance”, I’m being told by Paharmact that my use of the AllyAimovig payment assistance card has run out after only 2 mos of use and now I’m expected by my insurance company to pay $768 for a one month supply of Aimovig. This medication has been helpful and eases my migraines so much. Thankfully my neurologist gave me free samples to start me out and also the Ally card , which carried me for about 5 now and then I did a 3 mos supply frm my Employers suggested pharmacy plan, and paid $900 for that 3 mos supply. That was last year, but now I’m being told I have to pay $ 768 for one mos! Can’t afford that. 
1. Cheryl Picerno Moderator
 <inline-mention username="CommunityMember8514709" user-id="8514709"/>, It is unfortunate that situations like this arise far too often. Here is a link to an alternate assistance program to help pay for different medications. You may be able to utilize this tool to help you out and get the medications you need. https://simplefill.com/how-we-help/ I know there is an option for you to re-apply for the Ally card if you have already utilized the card. Let us know how you make out and if you can utilize the program. I hope this helps you. Warmly, Cheryl <a href='https://migraine.com' target='_blank'>migraine.com</a> team
Dixie Diamond Member
My insurance recently started covering Ajovy so I tried it. It left soda can size rashes at the injection site and greatly exacerbated my asthma. I stopped after 3 injections and went back to just using Ubrelvy.
1. Cody Leach Community Admin
 <inline-mention username="Dixie Diamond" user-id="3695027"/> Oh my! I don't blame you at all for not wanting to continue with Ajovy after such nasty side effects. Do you think you'll try a different CGRP in the future? - Cody (Team Member)
2. Holly Harding Moderator & Contributor
 <inline-mention username="Dixie Diamond" user-id="3695027"/> Sorry to hear of these horrific side effects! I'm curious to hear how Ubrevly is working for you? Warmly - Holly (team member)
Dixie Diamond Member
Ubrelvy works well, but not quite as fast as Imitrex. My insurance company only pays for eight 100 mg tablets a month so I try to just take a half a tablet at a time. My Neuro had me switch from Imitrex to Ubrelvy because the brain damage that Cymbalta did was leaving me at too much of an increased risk for stroke if I had kept on with Imitrex. I also take an OTC headache powder every morning (Goody's) and I get a magnesium sulfate IV (2 grm) every 4 weeks. Thank you for asking!!
1. Holly Harding Moderator & Contributor
 <inline-mention username="Dixie Diamond" user-id="3695027"/> Oh- I'm very interested in the magnesium sulfate IV. I've never heard of this- outside of the magnesium that is frequently placed in an IV as part of the migraine treatment cocktail during ER treatment. Where do you go for this treatment? Do you find this helps preventatively or as a rescue? Do you take any magnesium supplements on a daily basis? Many folks on our site report taking it as part of their prevention strategy: https://migraine.com/search?s=magnesium. I understand shifting away from the triptan due to its potential harsh impacts given your history. I am sorry that your insurance only gives you 8 Ubrevly a month. Very frustrating. Sometimes you can ask your doctor to write an appeal to increase that dosage. Thanks again for helping us understand your migraine treatment approach. It's very helpful to learn from one another! Warmly - Holly (team member)
CommunityMember416521 Member
Aimovig has made a big improvement in my overall life. It has not stopped my migraines, but in combination with Botox injections, my Chronic migraine numbers have gone from 20+ a month, down to 4 - 6 migraines a month. The pain level has also reduced dramatically. unfortunately, as I am writing this, I am experiencing my 4th day in a row with my "typical" migraine; eye / head / sinus / neck / shoulder / and upper back pain. My Neurologist recently added Nurtec to my abortive list, I usually use Sumatriptan Succinate as my abortive, and it works wonderfully. the Nurtec has not completely shut down the migraines. they are hanging around similar to the rebound medication over use headaches. God I hope not!! Well I am wandering off topic. Aimovig has been a life saver for me, so far. I hope it continues to work...
1. Holly Harding Moderator & Contributor
 <inline-mention username="CommunityMember416521" user-id="9820920"/> How interesting. Thank you so much for sharing some of your journey with us. First, so good to hear how much Aimovig (in combination with Botox) is positively impacting your migraine frequency and severity. We are happy to hear this. Second, as to the shift in your rescue treatment plan from a triptan to Nurtec - I'm interested why the change if the triptan was effective for you. And, interesting to hear that the consistency of the migraine pain has shifted to quiet but not stomp out the pain entirely. As we all know- that in-between type pain is not only an irritant but places us in that dangerous and fragile place where we can feel more vulnerable to triggering another attack with very little activity/input. If you haven't already, it would be worth asking your doctor about the reason behind the shift away from the triptan and to let him/her know what you are experiencing in case it makes sense to ditch the Nurtec plan and go back to the prior strategy. A huge part of life with migraine, as you are aware- is finding the most effective preventative/rescue treatment strategy that provides us with best chance of relief. Unfortunately, for a myriad of reasons, that efficacy can fade on a dime, or with time - for reasons we can't always figure out. When we experience a major improvement (like you did) in our condition, it can be troubling to consider losing ground. We are here for you to provide support, compassion, and information anytime. Please stay in touch! Warmly - Holly (team member)
wappaw Member
<inline-mention username="Holly Harding" user-id="3755969"/> Because I am 70, Triptans are a concern for possibly causing strokes. This is why my Neurologist was suggesting I try Nurtec, to possibly replace Imitrex / Sumatriptan Succinate. I told him that I would try but after all these years I did not want to upset the apple cart. If the stroke took me fast, so be it. After a fourth does of Nurtec, it appears it is starting to work to stop my migraines. Imitrex shuts them down in 30 - 40 minutes, not hours. My last refill of 9 sumatriptan was $3.09, Nurtec will be $140.00 for 16 tablets…
1. Cody Leach Community Admin
 <inline-mention username="wappaw" user-id="3905284"/> I'm glad to hear that Nurtec has been working, albeit not as good as sumatriptan was. The increase in cost is a real concern for many. I wonder if your neurologist would be okay if you switched between the two? That way, your risk of stroke is lower, but you also don't have to spend $140 every time you need to refill your medications. Just some food for thought! - Cody (Team Member)
2. Holly Harding Moderator & Contributor
 <inline-mention username="wappaw" user-id="3905284"/> You bring up such good points here. I was just visiting my GP (not my migraine specialist) and she, who also reviews my migraine treatment strategy, mentioned that she has a patient who, like me, takes triptans more often than most. Her patient takes them daily and is slightly older than me- in his 60's. She and I had a good discussion about the deep impact of chronic migraine and how, ultimately sometimes hard (or maybe not THAT hard) choices have to be made when discussing quality of life issues. I mean, would I like to live a long life in which I'm bedridden because I'm avoiding medications that are effective? Or would I like to have a semblance of a functional existence if it means taking medicine that comes with health risks? A rock and a hard place for sure, and a very personal decision, but I know which side I come down on. Expense is a whole other part of the equation! Thinking of you- Warmly - Holly (team member)