Regence Won’t Cover Botox for Migraine Relief



For many migraine sufferers Botox is the last possible chance for relief.  When they have suffered migraine after migraine and tried treatment or medication of every type without finding relief for their debilitating symptoms, some migraine sufferers turn to Botox.

This is not a decision made lightly.  For one thing, there has to be approval by the insurance company along with proof that the person has tried just about everything else without success or relief.  For another thing, a Botox treatment is no small issue.  Treatment usually involves injections into several sites including the temples, neck, back of the head and shoulders.  This is not something a person decides to do on a whim, nor is it something that someone like me, who is terrified of needles, decides to do because they just don’t want to try whatever else is available. In my case, I’ll try anything before I have to take a shot, much less, multiple shots.

Now, Regence in Washington State is eliminating coverage for Botox starting October 1, leaving the individuals who have tried every treatment and taken every medication without relief, with no coverage for the one treatment and form of relief that they have been able to find.

True, Botox does not work for everyone.  But, not everyone wants to even try it.  Most people are very content to take some of the excellent migraine medications available to either control or prevent migraines.  The people who move on to Botox are usually patients who get no relief from available medications or who have such strong reactions to the medication that they have to try something else. 

Regence says that it is discontinuing coverage for Botox treatment of migraines because it is not clinically proven.  If you ask the people whose headaches are better because they are using Botox injections, they will tell you different.  In addition, more and more research points to one cause of migraines being muscles that spasm, creating pressure on nerves in the head.  Since Botox stops the spasms and paralyzes the muscles, the logic is that somewhere there is clinical proof that Botox can help migraine sufferers.

Currently, there are studies being completed at the Swedish Headache Center.  Researchers and doctors there say that Regence has acted prematurely in discontinuing Botox treatment for migraines.  They have stated that the results of their testing and studies – to be released shortly – will prove without a doubt that Botox can control or eliminate chronic migraines.  Also, Allergan, the manufacturer of Botox plans to petition the FDA for approval to use Botox to treat migraine headaches.

Regence has stated that if sufficient information becomes available, they will reconsider their position.


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