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Lidocaine/Lidoderm patches

jamaleejjamalee Posts: 3
edited 12/09/2015 - 3:22 AM in Pain Medications
I'm new here and looked for but did not find anything about Lidoderm/lidocaine patches. I use them for bilateral torn rotator cuffs and hand and wrist pain due to wheeling a manual wheelchair for 25 years. I also have a herniated disk at L5 and have used them for that as well. When the disk acts up it causes constant terrible burning, crushing pain in my phantom lower leg as I am a right above knee amputee.

I had a series or cortisone injections in my back over a period of 2-3 years that finally stopped working. On the way home from the pain clinic after being refused an injection because the last one hadn't helped, I twisted hard to my right and bent over at the same time while sitting in the driver's seat of my van to look at my grandson who was sitting behind me and must have squeezed the disk back into place because the pain stopped that night and hasn't come back since except for mild episodes. When it does I do the same motion to make it go away.

Anyway, the purpose of this post is that recently, the FDA determined that Lidocaine patches are approved only for shingles. Therefore Medicare and Medicare advantage insurance will no longer cover lidocaine patches which are prohibitively expensive, $250 or more for a box of 30.

I just filed a complaint with the ADA for discrimination against those in this country who are being refused the Pain Medication they need for their quality of life. Here is the link for anyone who wishes to file a complaint for any medication or other treatment they have been refused:


Just use the search facility .. There are scores and scores of threads/posts that talk about Lidoderm/Lidocaine patches. How to use them, problems with them, generic brands etc.
I just picked up 2 boxes of Lidoderm patches. No problem with insurance. Diagnosis, use for chronic pain

-- Ron DiLauro , Spine-Health System Moderator 12/09/15 09:22


  • SavageSavage United StatesPosts: 5,427
    Welcome to Spine-Health
    Please click on link for helpful information!
    Spine-Health Moderator
    Please read my medical history at: Medical History

  • But do you have a Medicare Advantage plan or another type of insurance? It's medicare that no longer covers it. Or that is what my Medicare Advantage plan - Kelsey Care told me.
  • dilaurodilauro ConnecticutPosts: 9,842
    for medicare on December 1st, I opted for Medigap, (vs Medicare Advantage) which allowed me to select the insurance company for prescriptions. I did go with Medigap since the coverage seemed to mirror what I had prior to Medicare.
    I was told that they do provide reimbursement for those patches.

    Now, when I did pick up the last set of patches, I was not Medicare eligible and was using my previous insurance carrier.

    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • PlumbTuckeredOutPlumbTuckeredOut Philadelphia, PAPosts: 325
    One of the medications I take is labeled for alzhiemer's disease. by the FDA. I do not have alzhiemer's and the medication is prohibitively expensive however, it's not a scheduled drug. I have been taking the med for 11 years with no issues. I called my insurance carrier and was told and I still have the paperwork, "We do not have the authority to question why your doctor prescribes a certain medication."

    When I worked in pharmacy there were few cases when, even as a pharmacist we could question why the medication was being prescribed. We could question the amount of controlled drugs prescribed per day per month and were required to do so per the FDA with loads of red tape. (we don't really take that long to count 90 pills!)

    If you doctor prescribes a medication and the pharmacy tells you your insurance company will not cover the medication you have 2 options: one is to self pay. The second option is to have your doctor call the insurance company and request coverage based on the doctor's opinion an the other drugs available to treat this same problem. Insurance companies will usually cover it for a month, do a bunch of paperwork to try to get you to give up and then request another note from your doctor.

    Jumping through the hoops is what insurance likes people to do. If only we were as good at jumping through them physically as we do symbolically we wouldn't need them in the first place!

    Don't give up!

    Two roads diverged in a wood, and I took the one less traveled by...... (Robert Frost)
    I still don't know if I should have taken the one that said, "Caution! Dead End" (Me)
  • I'm replying to Plumbtuckeredout... Wouldn't asking my Dr to prescribe the patches for shingles when I need them for chronic pain due to torn rotator cuffs to get around the FDA's decision require her to put down a fictitious diagnosis in my medical records? I doubt she would do that.

  • dilaurodilauro ConnecticutPosts: 9,842
    That would be fraudulent and most doctors would never agree to doing that.

    Their license and reputation is on the line

    Have some done that? Yes, sure to help their patients. But that comes at a big risk if challenged
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • PlumbTuckeredOutPlumbTuckeredOut Philadelphia, PAPosts: 325
    edited 12/11/2015 - 8:19 PM
    Off label prescribing is alive and well in the United States. The doctor prescribes a med. Writes the prescription. Notes that a prescription number and strength of patches prescribed and how many refills. This information does not go to the FDA or the pharmacy. Only you have ownership of those files but nonetheless, off label prescribing is not illegal or fraudulent. Prescription fraud is writing a prescription for one person (who has insurance) but it's intended use is for a different person.

    I read articles ALL THE TIME regarding off label use of prescription medications. Most commonly this is done in the psych field. Few psychiatric medications are tested and/or approved for the use on young children. I just read a shocking medical article where children under 24 months of age were being prescribed neuroleptic drugs- heavy tranquillizers. It's legal but it's not responsible.

    A medication I take, Namenda, has the FDA approval for the use of treating Alzhiemer's disease. Because of the neurotransmitters this drug affects it's works well for OCD, for me. -Only about 10% of people with OCD. It would be clinically impossible for a drug to be retested for the use of OCD so it is prescribed "Off label". Again, when Prozac first came out in the market is was prescribed for depression. When the brand drug was coming close to losing its patent Eli Lily applied for a new patent for its use for anxiety. They presented the paperwork to show that it was effective for anxiety BUT doctors have been using it for anxiety long before the FDA allowed the makers to label this use.

    Another example- Wellbutrin. First this was prescribed as an antidepressant. 3 years later, same drug, new brand name, Zyban and it was presented as a quit smoking aid. So when the brand "Wellbutrin" became eligible as generic buproprion it said it was labeled as use for depression. However, the brand drug, Zyban was still holding a patent for smoking cession. Doctors prescribed the generic buproprion, labeld as an antidepressant, but to help those with smoking issues.

    Off label use is actual the way so many drugs are discovered for uses never initially tested for. Viagra was going to be a heart medication- still is but it's sold a lot more as an ED aid.

    There is no law stating that a doctor is not allowed to prescribe a medication for off label use.


    Two roads diverged in a wood, and I took the one less traveled by...... (Robert Frost)
    I still don't know if I should have taken the one that said, "Caution! Dead End" (Me)
  • PlumbTuckeredOutPlumbTuckeredOut Philadelphia, PAPosts: 325
    You can look up, "Is off label prescribing legal" It pops right up. I never before realized that people questioned this.


    Two roads diverged in a wood, and I took the one less traveled by...... (Robert Frost)
    I still don't know if I should have taken the one that said, "Caution! Dead End" (Me)
  • JAM661JJAM661 Posts: 121
    edited 12/14/2015 - 6:56 PM
    I tried this year to get the patches after someone gave me some to try and they really helped. However I am not getting them because my provider (part D) for my medications will not approve them even after my doctor stated the need for them. However the ointment is paid for by the insurance provider. If the ointment works to help with my back pain then why is the patches limited to just shingles? Of course we all know the reason. MONEY Of course instead of just being honest and stating that they use the excuse that studies have not proved that the patches work to decrease pain for other reason other then shingles. Which make you wonder if there was even any studies done to begin with.
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