Why insurance should pay for your next Botox shot

The US Food and Drug Administration (FDA) yesterday approved Botox injection to prevent headaches in adult patients with chronic migraine. Chronic migraine is defined as having a history of migraine and experiencing a headache on most days of the month.

In a statement, the Food and Drug Administration recommended Botox be injected every three months around the head and neck to dull future headache symptoms.

Some doctors claim they have been using the drug to treat migraines for many years even though it was not approved for it. The FDA’s approval will likely mean that insurance companies will pick up the tab for it although it is not clear how long it might take for local insurance companies to start the process.

Describing chronic migraine as “one of the most disabling forms of headache,” Dr Russell Katz, director of the Division of Neurology Products in the FDA’s Centre for Drug Evaluation and Research, said the condition can “greatly affect family, work, and social life, so it is important to have a variety of effective treatment options available.”

“Patients with chronic migraine experience a headache more than 14 days of the month,” he added.

However, the drug – whose generic name is onabotulinumtoxinA – has not been shown to work against migraines that occur 14 days or fewer per month, nor has it been shown to work for other forms of headache, said the statement.

Migraine headaches, described as an intense pulsing or throbbing pain in one area of the head, headaches are often accompanied by nausea, vomiting, and sensitivity to light and sound.

Migraine is three times more common in women than in men, the FDA statement noted. The condition usually begins with intermittent headache attacks 14 days or fewer each month (episodic migraine), but some patients go on to develop the more disabling chronic migraine, it said.

To treat chronic migraines, Botox is given approximately every 12 weeks as multiple injections around the head and neck to try to dull future headache symptoms. FDA, however, warned that it was “important that patients discuss with their physician whether Botox is appropriate for them” before queuing up for it.

The most common adverse reactions reported by patients being treated for chronic migraine were neck pain and headache.

The drug labelling warns that the effects of the botulinum toxin may spread beyond where it is injected to other areas of the body, causing symptoms similar to those of botulism, causing symptoms that may include swallowing and breathing difficulties that can be life-threatening.

“There has not been a confirmed serious case of spread of toxin effect when Botox has been used at the recommended dose to treat chronic migraine, severe underarm sweating, blepharospasm, or strabismus, or when Botox Cosmetic has been used at the recommended dose to improve frown lines,” the FDA statement said.