Living with MS migraines and navigating the ‘prior authorization’ trap

Dealing with multiple sclerosis (MS) — including the numerous symptoms that manifest differently for each person, the grief, and the uncertainty — is grueling. On top of all that, there’s the added challenge of navigating the American healthcare system.

As I have written before, I’ve dealt with migraines since I was 13. They were often extremely severe, lasting longer than typical migraines and leaving me immobilized for days at a time. No remedy, no medication, and no lifestyle adjustments relieved any pain. Living with excruciating pain became my version of “normal.”

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No relief

My previous neurologist placed me on Emgality (galcanezumab-gnlm), a monthly injection specifically designed to reduce the severity and frequency of migraines. I cannot fully express the difference this medication made in my daily life. For the first time in a long time, I felt human again.

I remained on this for about seven or eight years, and I only experienced a migraine once in a blue moon. Over the years, I encountered only a few minor insurance hiccups that were quickly resolved, none of which caused extensive stress.

However, about a year ago, I received a phone call from my local pharmacy saying they were unable to fill my prescription because they needed a prior authorization from my insurance. If I never hear those two words again, my life would be blissful. After countless long calls with my doctor, my insurance company, and the pharmacy, I had gotten nowhere. My prescription remains at a standstill.

For the first few months without my medication, I didn’t notice a difference in my migraine frequency and severity. But as time passed, I began having more migraines, which strained my daily life. My doctor has submitted multiple appeals; meanwhile, my migraines have intensified, bringing vomiting, eye pain, and dizziness. Still nothing.

Dealing with all the symptoms of MS is already a lifelong battle, but navigating a complex healthcare system and having to advocate for myself, only to be constantly silenced by the people who are supposed to help, is an added and unnecessary burden that no one should have to deal with.

Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to multiple sclerosis.