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help with insurance problem
1 Replies
bbass - June 18

I was diagnosed with fibro about 4 months ago, though have had it for a long time. My doc wants me to try cymbalta for the fibro pain, the horrible pms, and the depression and anxiety. Here is where I need help. My insurance says it will not cover it, that I have to try a step program...try all these comparable generic drugs like amitriphiline and something that starts with g, and flux-er-something, or the other. What should I do? Does anyone have any suggestion or opinion on other drugs used instead of cymbalta? So Frustrating!!!Pharmacy says it will be 165 for month supply.


Fantod - June 18

Don't you just love the insurance companies that interfere with your doctor's decision-making?

For your information, Amitriptyline is for sleep.
Fibromyalgia (FMS) interferes with your ability to get REM sleep. Your muscles can not repair themselves without deep sleep. The less REM sleep you get, the worse your overall pain will become. The longer the chronic pain cycle goes on, the harder it will be to get it under control.

Cymbalata is an antidepressant used to treat widespread chronic pain and the depression that accompanies FMS. I take it myself and it does help more than I thought possible. The other options are Savella (new to the market) or Lyrica.

I would call your insurance company and ask for a supervisor. Their step program sounds unreasonable and like pure torture to me. Get your doctor involved as well. Have them write a letter to the insurance company. They should say that it is critical to treat as prescribed. Something like "the high level of chronic pain must be treated as I have prescribed now or it may become even more expensive to treat later on. The chronic pain cycle will be extremely hard to break if the patient does not have ready access to the correct medication now as opposed to going through a step progam."

Ask your doctor for samples of Cymnbalta. If you can not afford the prescription, say so. There is no shame in that whatsoever. Unfortunately, there are only certain classes of prescription drugs that work for FMS. You can also go online to the drug manufacturer with your script and ask for assistance. They will give you a supply at little or no cost.

I hope one or all of these options are helpful to you. With FMS you must learn to think outside of the box and be your own best advocate. Take care.



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