The Food and Drug Administration recently approved a third drug indicated for treatment of fibromyalgia. Milnacipran, made by Forest Laboratories and Cypres Bioscience, is a selective serotonin and norepinephrine dual reuptake inhibitor. It will be available to consumers in March. &...
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Insurance and FM Meds
Karen Lee Richards
Friday, February 20, 2009 at 04:17 PMre: Insurance and FM Meds
Jenny Greiner
Friday, February 20, 2009 at 04:43 PMThanks for bringing this issue to light, Will. Yes Karen, my past insurance company refused to pay for Lyrica even after it was approved by the FDA for FM use. They replied to me that FDA approval does not give any medication prior authorization. I had to do the fail trial method that Will spoke about. It took 4 other meds and 9 months to get approval for the Lyrica. I am currently in a fight to get Provigial approved, even before FDA approval for FM, so that I get a head start in my "drug failure" program.
Jenny
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I hadn't heard that some insurance companies were refusing to pay for the new FM meds. I find it interesting that they can get away with that for two reasons:
1) I've heard from some who said off-label meds were rejected by the insurance companies because they had not been approved for their particular diagnosis;
2) How can they require doctors to prescribe off-label first when there are approved drugs available? Pharmaceutical reps aren't allowed to promote off-label uses, but insurance companies can insist they be used first? Very strange.
Thanks for sharing this info. I'll look forward to seeing the results of your survey. (Unfortunately, I don't have insurance, so I can't participate.)