Say you have a bad back. Yesterday I gave you $4,000. Enjoy!
Today I’ll focus on saving money on medications that are used for back pain. There are other modalities which we’ll discuss another time (e.g. exercise, weight loss).
Classes of medications that are commonly used to treat back pain include: anti-inflammatory drugs, muscle relaxers, pain medications, and topical treatments.
Of the anti-inflammatory drugs, there’s the non-steroidal group (NSAIDs) and the steroidal group. The NSAIDs work well, and can be used chronically or as needed.
The most common side-effect is stomach irritation. Because of this potential, Celebrex® was developed, an NSAID-like cox-2 inhibitor that is less likely to cause GI irritation. But it is expensive. Self-pay patients can expect to pay about $137 for a month’s supply of 200 mg, or $85 for 100 mg at a discount pharmacy. If your income is below $45,000 and you are not a Medicare patient, you may qualify for the Together Rx Access program for discounted drugs. You can also check online for coupons to offset your cost or your co-pay. If you have insurance, this drug is likely to be a 2nd or 3rd tier, requiring a higher co-pay than generic drugs.
But most patients do not have sufficient stomach irritation to warrant the use of Celebrex. If you do have a problem, a second option is to use a $4 GI medication (see entry, Save money on heartburn) to lower your stomach acid, which may allow you to use a $4 NSAID. Some of these are over-the-counter, but it’s important that you consult your doctor with questions of drug interactions and other side-effects.
One list of $4 generic NSAIDs includes: diclofenac, ibuprofen, naproxen, indomethacin, meloxicam, and piroxicam (at Wal-Mart). Print this list and take it with you to your doctor. Over-the-counter NSAIDs include ibuprofen, naproxen, and aspirin.
The Wal-Mart $4 list also includes prednisone, dexamethasone, and methylprednisolone, three steroids that can be used in an acute situation.
Of the muscle relaxers, baclofen and cyclobenzaprine are on the $4 list. These are especially useful when your back muscles are tight, or if you cannot sleep. Drowsiness is the most common side-effect. Skelaxin® currently comes only as a brand-name, and costs 20 times as much – or more! Skelaxin offers a $30 printable coupon at http://www.skelaxin.com/.
Straight pain medications are also useful. Tylenol® (acetaminophen) provides sufficient relief for many people. It can often be used with an NSAID – but consult your doctor first. Excedrin® is an example of a single pill that includes both.
The non-narcotic drug tramadol (generic Ultram®) is quite inexpensive (is on some $4 lists) and is very effective.
Topical preparations such as the Flector® patch or crèmes such as Voltaren® Gel are also effective but expensive. If your doctor prescribes these, check online for a $30 coupon. I’ve had patients who’ve found topical crèmes at the dollar stores that they claim work just as well. If it works for you, go for it.
According to Dr. Michael Roizen at the Cleveland Clinic, 65 million Americans suffer from back pain. (See http://ask.doctoroz.com/question/how-common-is-back-pain.) I’m one of them! Join me in saving America a billion dollars.
Potential annual savings on back pain:
65,000,000 patients x $20 apiece (a modest claim) = $130,000,000
Actual savings: Readers, let me know. Please share your success stories or ideas to help others by sending an email to: firstname.lastname@example.org
© Cynthia J Koelker, MD – All Rights reserved
- Pain Treatment Is the Best Yet (technologyreview.in)