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GoodRx in Action: Migraine Relief When Insurance Wouldn’t Pay

by Elizabeth Davis on September 24, 2014 at 3:12 pm

We get lots of questions from folks who don’t understand how GoodRx works or how it can help them. Over the next few months, we’ll provide a few short examples from Americans who have used GoodRx to understand and control their healthcare costs.

Marie, a woman who lives in Texas, experienced her first migraine at 18. Today’s migraine drugs hadn’t been invented yet, so she would lie in bed for days, sometimes needing a shot from the doctor for the pain. When she was prescribed her first migraine medication in her thirties, she considered it a gift.

Today, drugs like Maxalt (rizatriptan) or Imitrex (sumatriptan) can stop a migraine, or at least make it more bearable. However, they work best when they’re taken at the first sign of symptoms. It’s much harder to get rid of a full-blown headache than to catch one as it starts.

Maxalt was a life-saver for Marie, and when she started taking the drug, her insurance paid for 24 tablets per month at a very reasonable $20 co-pay.

A few years back though, her plan decreased her limit to 15 tablets for $20, and then to only four generic tablets for $9. While her co-pay was low, her insurance wasn’t covering enough medication. Frustrated, she asked the pharmacist how much the full 24-pill prescription would cost. The response: $900. Yes, $900, for the generic.

Marie and her doctor have both appealed to her insurance provider, but they haven’t budged—four tablets per month is all they’ll cover.

She’s been making do with only four Maxalt each month for nearly two years.

When seasonal temperature fluctuations brought on week-long headaches, she held on to her limited supply and suffered; there was always a chance the next day would be worse. She felt like she was back to the old days, where all she could do was lie down in a dark room.

Marie first heard about GoodRx through a friend whose husband was also having trouble with his insurance. She wasn’t sure if it would work for her, but she thought it was worth a try. She asked her doctor for a prescription for the 18 Maxalt tablets her insurance wouldn’t let her have, and took it to her pharmacy with a GoodRx coupon.

A few minutes later, the pharmacist returned to the counter, handed her the full prescription, and charged her $39—95% less than the cash price she had been quoted.

She took a minute outside the pharmacy window just holding the coupon and giving thanks.

At around $50 for 24 Maxalt tablets instead of almost $900, Marie saves over $10,000 per year. Now, she can afford her medicine and she has peace of mind knowing that she’ll have relief when she needs it.

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