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#truemigrainepose

This photo is not a glamorous temporary facelift intended to show off my manicure, despite what Elle magazine might claim. Nope, it’s me trying to get at least a little work done during a migraine attack.

According to Elle, #migrainepose is a trending Instagram pose that’s “damn flattering.” I wish I’d know how beautiful I looked all these years that the pain-induced furrow between my eyebrows has been deepening into a rut.

We at ELLE.com love a weird Instagram pose, and the latest one populating on our feeds is giving everyone a headache. Well, it’s making everyone deliberately look like they have a headache. And it’s damn flattering.

Migraine Pose, coined by makeup artist Nam Vo, involves posing with one or two hands pulling your face up by your temples as if you had a, well, migraine. There’s a reason it’s trending: The pose tightens the face, makes your cheekbones look more prominent, and lifts the brows. It’s a temporary facelift for the ‘gram.

“I love it because the beauty of your hands frame the face and give it more structure. I always make my models pose this way,” Vo told me, “It’s also a great time to show off your manicure.” #Priorities.

My #priorities are reducing the stigma of this disabling disease that can rob people of any semblance of a normal life, teaching those without migraine how that migraine is so much more than “just a headache,” and trying to live as well as possible with a life that’s dictated by a terrible illness. Granted, showing off my beautiful hands and giving my face more structure are probably loftier goals. Perhaps I could have pursued those important priorities if I hadn’t spent most of my adult life disabled by migraine.

Ways to fight back against this blood-boiling migraine stigma:

  1. Post a photo of yourself during a migraine attack to social media with the hashtags #truemigrainepose and #migrainepose
  2. Tell Elle what you think of their perpetuation of migraine stigma. Twitter: @ellemagazine, Instagram: @elleusa, Facebook: @ellemagazine. You can also email them at editors@elle.com or contactus@elle.com. **Do not use “migraine” in the subject line! These messages are being returned as undeliverable, while those with blank subject lines go through!**
  3. Tell Nam Vo, the makeup artist who coined the term, what you think, too. Instagram: @namvo

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Aimovig Insurance Coverage: Will Insurance Cover Amgen’s New Migraine Prevention Drug?

Do insurance companies offer Aimovig insurance coverage?

Depending on the insurance company, Aimovig insurance coverage could already be available! Some readers have reported success with getting insurance coverage already. 

My insurance company told me Aimovig came out too late to be included on their current formulary, which is updated twice a year. I was told they’ll make a determination for the January 2019 or July 2019 formulary. As a fellow advocate pointed out, if this were a cancer drug, insurance companies would be unlikely to tell patients they have to wait six months to a year to learn if it will be covered. If I decide to continue with Aimovig after the free trial, I will actively pursue coverage, which will certainly involve letters from my doctor and insurance appeals. I’ll let you know how it goes.

If it’s not available yet, will Aimovig insurance coverage eventually be available?

The likelihood that insurance companies will cover Aimovig and other CGRP-inhibitors is promising. ICER, the organization that insurance companies look to for guidance, issued a report on May 31, 2018 that CGRP-inhibitors are a cost-effective treatment for both episodic migraine and chronic migraine. The migraine advocacy community was pleasantly surprised by this news and is hopeful that it bodes well for coverage. ICER has yet to make its final determination and insurance companies are free to make their own decisions no matter what ICER determines, but we’re in better shape than expected at this point.

The bottom line? Check with your insurance provider now to see what their policy is and, if they aren’t covering it yet, when they plan to make a decision. (And know it’s worth going through the appeals process even if they say they don’t cover it yet. If nothing else, if you have commercial insurance, that will make you eligible for Amgen’s Bridge to Commercial coverage program.)

Will Medicare and Medicaid cover Aimovig?

Probably yes, eventually. I know that’s a lot of equivocation! Medicare and Medicaid are usually slower to adopt medication coverage than commercial insurance companies are. The ICER report could work in our favor though, especially if it’s considered more cost-effective than Botox, which Medicare and Medicaid do cover.

Patience and Optimism

Advising people to be patient is tough—we’ve already waited so long for the first CGRP drug to become available. Though I do think coverage will come sooner than we might expect. I can’t overstate how important it is that ICER’s report determined that CGRP-inhibitors are cost-effective for people with chronic migraine and those with episodic migraine. Combined with Amgen’s two-month free trial and Bridge to Commercial Coverage program I wrote about yesterday, people with commercial insurance have a promising outlook.

Unfortunately, I know many of you have state or federal insurance, which doesn’t benefit from these programs. The disparities in access to medical treatments makes me sick. If you have Medicare Part D, you may be available for coverage through the Amgen Safety Net Foundation

How about you? Do you have Aimovig insurance coverage? Please leave a comment and let us know what your experience has been like?

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How to Pay for Aimovig, Amgen’s New Migraine Prevention Drug

How to pay for Aimovig? Will insurance cover it? How am I paying for my first dose? These are the questions I got when I posted the delivery date of my Aimovig to Facebook. My insurance isn’t covering it yet (though some insurance companies are), but I’m not paying for it either. My first two doses are coming free through Amgen’s two-month free-trial. If my insurance won’t cover it after that, Amgen will pay for up to another 12 months of doses while I go through the insurance appeal process. Those are two of Amgen’s four programs to help pay for Aimovig, only one of which requires demonstrated financial need. This post describes those four options. Tomorrow I’ll talk about insurance coverage, which is looking quite promising for patients with commercial coverage. [Update: Aimovig Insurance Coverage: Will Insurance Cover Amgen’s New Migraine Prevention Drug?]

Note: You may be eligible for several different programs, so be sure to read through all the options.

My knowledge on these programs is limited to what I’ve shared here. If you have questions, please call Aimovig Ally at (833) 246-6844. I found their customer service incredibly helpful and responsive. And I’d love if you leave a comment sharing what you learn so we can all know more about the programs!

How to Pay for Aimovig, #1: Two-Month Aimovig Free Trial

The two-month free trial is available to all new Aimovig patients (except those who live in Massachusetts or have participated in a clinical trial). Participants will receive two months of Aimovig (either 70 mg or 140 mg each month, depending on what your doctor prescribes) at no charge. There is no continuing obligation. You must enroll by Dec. 31, 2018. See page 4 of this Aimovig prescription form for the legalese.

(My first doses are through the two-month free trial. It was super-easy. I filled out the paperwork through my doctor, who submitted it to the Aimovig Ally pharmacy. The pharmacy called me about a week later to arrange delivery. A nurse also called to offer injection training—she’ll be on hand for my first injection to show me exactly what to do. I have heard some people in other parts of the country have waited weeks with no call from the partner pharmacy—I suspect that distribution facilities in different regions have differing supply levels or responsiveness.)

How to Pay for Aimovig, #2: Up to One Year of Free Aimovig While Waiting for Insurance Approval

The “Bridge to Commercial Coverage” program provides up to 12 months free to patients while they are pursuing insurance coverage. To qualify, you must have commercial insurance (state or federal coverage, like Medicare or Medicaid, don’t qualify) and your insurance company has to have denied your request to cover Aimovig or not cover it at all. You also need a valid prescription for Aimovig and have tried at least one other preventive without success. You must enroll by Dec. 31, 2018. Massachusetts residents are not eligible for the program.

This program requires that you (and your doctor, if necessary) are actively pursuing insurance coverage and appealing denials while you’re receiving the free doses. Page 4 of the Aimovig prescription form has details about the paperwork that might be required.

How to Pay for Aimovig, #3: Aimovig Copay Support

Patients with commercial insurance can reduce out-of-pocket costs to as little as $5 per month (with a $2,700 annual maximum savings). Eligibility is not based on income. Since the details of this program may change, please see Amgen’s Aimovig copay support information for specifics. You cannot use copay support if you have state or federal coverage, like Medicare or Medicaid.

How to Pay for Aimovig, #4: Prescription Assistance for Those with Demonstrated Financial Need

Here’s the wording of the program directly from Amgen since I don’t have firsthand experience with it.

“You may be able to receive Aimovig™ at no cost from Amgen Safety Net Foundation if you meet the following eligibility requirements:

  • Resident of the United States or its territories
  • Those in one of the following insurance situations:

o Uninsured

o Patient’s Insurance Plan excludes the Amgen product

  • Patient demonstrates a financial need: Income at or below 500% of the federal poverty limit (FPL) [According to the Amgen Safety Net Foundation website on June 12, 2018, that’s currently $60,700 for a household of one; $82,300 for a household of two; $103,900 for a household of three; $125,500 for a household of four; and an additional $21,600 for each additional person.] 
  • Certain standard Medicare Part D patients with product coverage that cannot afford their out-of-pocket costs may be eligible. These patients must:

o Meet additional financial criteria demonstrating their inability to afford the product

o Not be eligible for Medicaid or Medicare’s low-income subsidy (LIS)

o Satisfy all payer guidelines and prior authorization (PA) requirements prior to applying for assistance

o Not have any other financial support options”

You can learn more at the Amgen Safety Net Foundation website and on the Aimovig prescription form.

What’s been your experience determining how to pay for Aimovig? Please share your story in the comments.