Lyrica, Insurance companies stink

Ok, I have been on Lyrica for about three years now. Our health insurance changed in September so now they have rejected my prescription of Lyrica. I take a massive amount of Lyrica. 600mg a day.... they are only allowing me 150mg per day. It has been in a national appeals process for two months now.... and now I about to run out and here's my question. I can't live without it, is there anything that any of you know besides neurontin(took that for years, but the insurance company won't let me have but one of those a day also), I just don't know of anything else... I have gained so much weight on lyrica, I read a post about a medicine that the person took that made you loose weight.... oh course I can't find the post now. It makes me so mad that the appeals letter has sat on someone's desk for two months, they don't understand that you can't survive without it.... no one gets in a hurry and you can't talk to them, it's like the great and powerful oz..... and I'm dorthy

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I would contact the company that makes Lyrica and find out if they could help with the cost and amount the you have to use. I hope there is some way that you can get your medicine. It is a crime that the insurance companies have a say so in how much medicince they are willing to pay for. I had the same problem with my Nexium. The doctor wanted me to take it twice a day and they did it for 2 months and then said that the medication is not to be prescibed that way. Who gave them there medical license? It is really crazy but what can we say. I am on medicare now and have to be careful about the cost of my prescription because of the donut hole in medicare Part D. I hope this helps you some because everyone has a medicine problem and I hope you get the help you need. God Bless

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Dear Csublett,
I am sorry you are having problems getting your medicines because of your insurance company. I dont know why but it could be because of the dosage and possible side effects, or it could be to save money. Anyway, I dont know a whole lot about Lyrica or what you are taking it for. I have seen on tv and read that is for fibromyalgia. Do you have fibromyalgia as well as scleroderma and other autoimmune diseases? I have been diagnosed with CREST/Scleroderma and fibromyalgia. If you are taking lyrica for muscle aches and or fibromyalgia then I can understand your pain. For years I suffered from the muscle and joint pains. I still do but its much better since I discovered that alot of the problem was delayed food sensitivity. I was tested for this a few years back through SAGE testing. Its amazing how much it has helped me. Everyone has different sensitivities that can cause illness and autoimmune responses. Sometimes its difficult for me to stick with it, but when I do, its quite remarkable. If you want to learn about it you can go to Sage Testing on the internet. I hope it will help you and that you can get the pain relief without the drugs. Wishing you the best.


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I am sorry to hear that but I agree with wayresh contact the company. I too take Lyrica and I do know what you mean when you say you need it. I dont understand how they can do that to someone you have to be weened off it you cant just stop taking it. I am lucky our insurance didnt change from last year. What are people going to do?

I was wondering do you think your doctor could give you samples?

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Most drug companies do offer a patient assistance plan for those who are uninsured or whose insurance doesn't cover the drug. I would look into that.

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I had an issue with Sporanox for fungal lung infection. My BC/BS did not want to pay for it because they said it was on the formulary List????? that it was a non-formulary drug and they wouldn't cover it. They were willing to pay for a generic. The generic made me very ill and after a month and a half of being sick I called the insurance company and explained it all. (The Sporanox costs $976 per month) They sent me a form for the doctor to fill out about how I needed the Sporanox in liquid form. That form was sent to the insurance company's "committee" to decide if it was necessary. They did agree to pay for 80% of it. Check with your insurance company about an appeal process. I know how I felt when they said they wouldn't pay for it. I almost paniced because they said I would probably get the fungas back if I didn't take the medicine and a second infection would be life threatening. I am still on the med until at least thru February. Good luck to you, don't give up.

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There are studies that indicate that 300mg is the maximum daily dose, however, they also say that doses up to 600mg daily can be given. With neurontin, as you step up each dose, you actually get less benefit, in other words, double the dose of neurontin is not double the effect, because you don't absorb that much.

Also, Lyrica is renally cleared, and they don't like to give it to people with kidney issues.

I would do as others have said, and see if you can get additional doses thru a patient program. I would not count on getting more than 600mg per day, since that is over the recommended dose.

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I took Neurontin for years and years. I took 3200mgs a day. I have been on Lyrica about three years now. I take one 150mg capsule in the morning and three at night. I have had Crest scleroderma for 20 years but now have lung and heart involvement so I guess I've graduated into systemic. I have fibromyalgia too. That is what I can't get under control. I take the Lyrica for that. I was diagnosed with that about four years ago.
Yesterday I received the dreaded appeals letter from my insurance company saying I was denied to have that much Lyrica. This is a new insurance company that the company has went with, I'm sure to save a buck, I took this dose for three years with my other insurance and there was never any questions. Wow the premiums go up and coverage goes down. I have to take two prevacid a day because of the damage done to my esophagus and now Barrett's Esophagus disease and that had to go thru an appeals process also, just not on the national level. We've only had this insurance since Sept. You know it was the healthy people at work that make the decisions on health care. I told them there should be a sick person to sit in on the meetings with the health care companies that pitch their ways of saving the company money.... that's the bottom line, and people that do not live everyday with the pain of a life long health problem DO NOT UNDERSTAND what we all go thru on a day to day basis.
I forwarded it on to the HR dept. to see if there is anything they can do to help. Please pray for me.

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Hey Little Darlin', I am so sorry you are going through this. I have a feeling I will too because I have had a dramatic change ion insurance. I made sure I had atleast 3 to 6 months of refills before 2009 ended. As of this very moment, I have no insurance at all. The social security office lost all my medicare papers. I have to go in tomorrow to do them all over again. Anyway, I digress. . .The other people who have responded are correct when they say to contact the drug company about help. You can probably get information about it online. As for the Neurontin, the generic is gapentin or gabpentin or something along those lines. I believe it is on Walmarts generic drug list. All you need to do is have your doctor write the prescription for what dosage you need (preferrably in a 90 day supply, cost $10.00). You do not even need to involve your insurance company in this matter.

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