Is it true that the only "approved" use of lidoderm patches is for post-shingles pain?
- 8 Aug 2011 by 2young2feelthisold
- 7 Apr 2018
- lidoderm, pain, back pain, herpes zoster
I've never had a herpetic condition (including shingles), but several years ago lidoderm patches worked wonderfully for my upper back pain. In fact, the patches allowed me to eliminate all prescribed oral pain medications at the time.
For whatever reason, that same upper back pain has returned. But now I am on a different insurance plan (Medicare), and have been told my new lidoderm prescription is not covered because treating pain in the ABSENCE of a history of herpes is not an "approved" use of this drug. What gives??
More than likely it's the cost part for the insurance. I have been on Lyrica for my fibromyalgia, which is the best treament for shingles pain by the way, & all of a sudden my insurance decided they didn't want to pay for it anymore until I tried a whole list of other meds ( that I have already tried before they were even my insurance co.). I just finally gave up, but your doctor can write them a letter or call them & explain you have tried other things that don't work...
this past winter I caught a fall (I already live with Chronic pain I have neuromuscular problem caused and aggravated by me having polio) this fall fractured 4 vertebraes in my back and some discs, Lidoderm did not totally eliminate the need for pain medications but my doctor is an internal medicine doctor with subspeciality in pain management, she contacted the insurance company but it was to no avail, I paid for 2 boxes and it really did make a difference, the cost was in excess of $275.00 per box I was fortunate that I had put money back for such a situation and it was well worth it, if I had been in a p- osition to where I had to use these much longer I think the drug company was willing to see if they could help but I was able to use other meds along with the pain medication and this got me over the hump
Yes, lidoderm is approved for shingles pain only but is often used "off label" for other pain conditions. Medicare, unfortunately, wont pay for them for "off label" use, usually. Your Dr might try to get an exception request for the drug however, if he applies for it and supplies documentation to the fact that it is medically needed. Ask the Drs office if they would be willing to do this for you. You may have to pay a higher copay though.
I can't help you much with insurance or Medicare because I have neither. I use 2 to 3 boxes of Lidoderm patches a month for Fibromyalgia muscle pain. I know that you can contact the Drug Company and request the papers for assistance with medications you can't afford and I think those not covered by your insurance company. Part of the form is your financial information and the rest is for your doctor to fill out. The doctor's office will more likely help you out if you do the upfront leg work and order the papers. This might help until your insurance decides to pay. My prescriptions are over $3,500.00 a month and I do not qualify for any type of assistance! I also have to pay cash for all medical treatment so it will not be long before I qualify for low income because as time goes on we are going to run out of assets to liquidate! I wish you the very best of luck because I've been in your position before when my husband had spinal meningitis and we had no income. I learned a lot about our "great government programs" during those 2 years!
I am a recently retired nurse with severe back issues. I had been on Lidoderm patches for about 10 years. I would not have been able to work without them.
Then, came signing up for Medicare. They made me go through 3 appeals, with letters from 2 of my doctors, stating I could barely function without them, and surely did not want me on pain meds.
Well, after the third regection, I got this from Medicare: "We will not do any off label use for anything". They are scheduled for post- hepatic neuropathy, (shingles), only. I am out now, several months without any, was very active, now, not so much. Aspercreme just started a 4% patch over the counter... Lidoderm is 5%, and they are about 8 bucks for FIVE!
I just don't get the labeling rationale. As a nurse, not only for myself, I have seen thousands of patients getting these prescribed... as I did for over 10 years.
Really, would a company stay in business, with such a limited label usage? I think not. So I can't exercise, could not function at all on any kind of pain med, and I am just getting worse back pain from lying in bed so much, and feel 10 years older, in less than one. The answer, then, is yes, sadly it is so very true!
I use a lidocaine 5% ointment for my pain. I can use it in each area up to 4 times a day. It does help me when my pain meds don't. If my pain is really bad I put this on and take a pill and I am usually ok for a bit. I suffer from fibromyalgia, scoliosis, sciatica and degenerative disk disease.
I like many others NEED these patches. I suffer from fibromyalgia, scolisis, sciatica and two areas of degenerative disks diseases. Used these patches for years and they enabled me to have some form of life. Other medicines doesn't begin to help with my pain and they are expensive. I thought Medicare was suppose to help us. Hasn't anyone written personally to Medicare letting them know many of us need those patches for pain? If you have, what was their response?
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