How Much is a Headache / Migraine Worth to You?

I get migraines, regularly. I have one right now since mid-morning and I’m just now feeling better enough to use a screen(1)as in it’s now more like a headache than a migraine. Still painful but I can read stuff Recently the Botox has been working pretty well at keeping them more in the “headache” range in terms of pain and greatly reducing the frequency as well, often down to less than one a week(2)From 3-4 a week.

COVID has thrown many things up in the air and has made getting Botox from my Neurologist more challenging to schedule. I’m currently about 6 weeks past due for my most recent treatment and the last 2 weeks have been painful. I thankfully have an appointment in 9 days, but I suspect the next 14 days will be challenging.

Apart from Botox I also have meds for my migraines. After a lot of trial and error and many many rebound headaches(3) A shitty side-effect of many 5-HT meds (triptans) is that it’ll cure your headache, but cause another in ~24h I use Frova. I only get about a 50% success rate when using Frova, but it’s the only one of the Triptans that didn’t consistently create rebound headaches.

Frovatriptan(4)the generic name of Frova costs just under 20CAD a pill in Canada, in the US, a quick google seems to indicate that it should cost about $30USD without insurance.

So on average, it costs $40 to stop a migraine. Thankfully my insurance covers 80% of this(5)As much as people say the benefits at the government are good, the health plan isn’t that great, my previous plan covered 100%, but that means it’s still $8 per migraine.

As I’m sure you can guess, Botox ain’t cheap either. It’s basically $900CAD for the medication itself, and then another $150CAD injection fee. 80% of the 900 is covered, but no part of the injection fee is covered.(6)Now there’s some fun stuff that happens here where sometimes you can qualify for a rebate from the manufacturer of the name brand, where they pay part of your portion. I’m not sure how they position this, but basically they get the insurance to pay more than the generic would cost but re-imburse part of it to the patient. All that to say, it’s usually around $100 that I pay instead of the $180 that would be the 20% So basically it’s 250$(7)see calculations in previous footnotes for why it’s not $330) every 3 months.

Again, this is with insurance. I also take 2 other medications for the migraines as daily preventative, but those cost less((“Only” about $60 a month.

For some reason we still don’t have a national pharmacare plan.

I don’t know how much is should cost to fix a migraine, but it probably shouldn’t be close to $8 000 a year. There should never be a $8 000 barrier stopping you from being able to participate in society.

Canada is the only country in the world with a universal health care system that excludes prescription drugs. It’s time to fix that.

Footnotes   [ + ]

1. as in it’s now more like a headache than a migraine. Still painful but I can read stuff
2. From 3-4 a week
3. A shitty side-effect of many 5-HT meds (triptans) is that it’ll cure your headache, but cause another in ~24h
4. the generic name of Frova
5. As much as people say the benefits at the government are good, the health plan isn’t that great, my previous plan covered 100%
6. Now there’s some fun stuff that happens here where sometimes you can qualify for a rebate from the manufacturer of the name brand, where they pay part of your portion. I’m not sure how they position this, but basically they get the insurance to pay more than the generic would cost but re-imburse part of it to the patient. All that to say, it’s usually around $100 that I pay instead of the $180 that would be the 20%
7. see calculations in previous footnotes for why it’s not $330) every 3 months.

Again, this is with insurance. I also take 2 other medications for the migraines as daily preventative, but those cost less((“Only” about $60 a month

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