My insurance co. refuses to pay for it and now my P.A. doesn't want to prescribe it because the insurance co. says it's only for cancer pain. This med is so effective for my breakthru pain and now I'm back to being in bed with pain and doing only basic activity.I have spinal and arachnoiditis.
The indications on rxlist.com are evident for you to read & possibly discuss it with your doc.
The med has been indicated for: Actiq (oral transmucosal fentanyl citrate) is indicated only for the management of breakthrough cancer pain in patients 16 and older with malignancies who are already receiving and who are tolerant to around-the clock opioid therapy for their underlying persistent cancer pain. Patients considered opioid tolerant are those who are taking around-the-clock medicine consisting of at least 60 mg of oral morphine daily, at least 25 mcg of transdermal fentanyl/hour, at least 30 mg of oral oxycodone daily, at least 8 mg of oral hydromorphone daily, at least 25 mg oral oxymorphone daily, or an equianalgesic dose of another opioid daily for a week or longer. Patients must remain on around-the-clock opioids when taking Actiq.
This product must not be used in opioid non-tolerant patients because life-threatening respiratory depression and death could occur at any dose in patients not on a chronic regimen of opioids. For this reason, Acitq is contraindicated in the management of acute or postoperative pain.
Acitq is intended to be used only in the care of cancer patients and only by oncologists and pain specialists who are knowledgeable of and skilled in the use of Schedule II opioids to treat cancer pain.
Take care, best wishes!
I am sorry to hear this.But do you have cancer? I would like to share a story with you.About 7 years ago I was on this sucker.And honstaly i thought it was a God send untill the harsh reality set in that my neighbor was stealing them.[Long story I won't go in to] So I had to go to rehab and get off of them.But That was the GOD SEND part that I didn't know untill later.While I was on this med I had a surgery and litterary screamed in pain,NOTHING they gave me in the hospital worked.I wanted to die from the pain of the surgery.Can you take ANYTHING else for your pain?Because beleave me I know that if something bad happens to you Bad car wreck ect, God forbid.
When you are in severe severe pain if you stay on this med.the Dr won't be able or willing to give you anything strong enough to help you.I know this from my own hell I was in.So PLEASE reconcider this med.I know this med does work.But you will find that unless you do have or get cancer.That that is really what this sucker is needed for,I hope that in NO WAY that I have offended you That is in NO WAY my intentions,Can you use the patch? Finding any Dr to give you this for break through pain without cancer is almost impossable,I have great ins. And they no longer will pay unless you do have cancer. I wish you all the pain free days you can get out of life. God Bless
The above comment is not correct in that Actiq can only be used for cancer pain. In fact, almost 80% of the Actiq Rxs are for off label use, or non cancer pain.
As my PM says, the human body cannot determine the different types of pain. Who is to say that cancer pain is worse than a burn victim, a person with an unstable spine, or someone severely injured in an accident?
Cephalon applied for a broader label, but was restricted to a cancer only indication due to it's potency. Fentanyl, the main ingredient in Actiq, is the same med used in the patch, and it's approved for a broad label, including back pain.
Any Dr in the US can Rx any drug for any reason they see fit. I would agree with the poster in that this med should be mostly Rx'd by pain specialists, who really understand the effects of the med. Your Doc and his PA is perfectly able to use Actiq if they think it's needed.
The reason insurance companies balk at paying is due to it's high cost and they use the cancer indication as an "out" to not cover the med. When Actiq first came out and was very affordable, just about every insurance carrier paid for it. Only after a series of serious price increases did insurance companies stop paying. Had it stayed cheap, this wouldn't even be an issue.
Lastly, if you want to look at the perfect definition of hypocrisy, look no further than our own gov't. The FDA says Actiq should be "cancer only", yet it's the # 1 pain killer used by our own military for battlefield injuries.
You might run this all back through your Doc to see if he will re-consider. Even if insurance won't pay, you can always pay cash, or retail price. Or, do what most Actiq users do, and that is use a compounding pharmacy, where it is much, much cheaper.
Best of luck to you!
- Actiq Information for Consumers
- Actiq Information for Healthcare Professionals (includes dosage details)
- Side Effects of Actiq (detailed)
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