Looking for info about insurance coverage of 15 fentanyl patches/month

I'm not sure what my PM doctor is going to recommend when I talk to her about what has been going on.

There could be four possible outcomes given that I stay on the patches rather than switch to a different opioid.

• Increase dosage from 50mcg/hr patch every 72 hours to 75mcg/hr every 72hours.
  
• Stay on the 50mcg/hr patches, but change every 48 hours instead of 72 hours...so 3 boxes(15 patches) per month.
  
• Add a BT pain med that actually helps. My current BT pain med is 1-2 50mg Tramadol tablets up to 3x per day. The Tramadol no longer helps at all even if I take the maximum amount that I am allowed.
  
• Now I can't think of the 4th, but there was one. I will update with it when I remember. LOL
  

Another option would be to try a totally different opioid such as OxyContin, MSContin, Dilaudid ER(Exalgo), Nucynta ER or Opana ER. I'm sure there has got to be more or maybe I covered them all.

The thing I like so much about the Fentanyl patch is that it is always working. It doesn't wear off in the middle of the night and I don't wake up in extreme pain and have to wait an hour or two for my pain medication to start working. I can just wake up and start my day like normal people for the most part. I mean, all of us CP'ers have our bad days regardless of whatever pain medicine we are on.

I know I wouldn't trust the ones that say you only have to take one pill a day for 24 hour relief, it just seems too good to be true. I might go for one that you take 2-3 times a day but I really don't see how one pill can provide good pain relief for 24 hours.

I guess there is the Butrans patch too but isn't that mostly a maintenance drug for drug(heroin) addicts? I wouldn't want to use Methadone either for that same reason. If I have to go to the ER for something or I see a new doctor I'm already treated like a drug-addict until I fully explain myself and those two drugs would just make it worse.

I've never taken morphine orally, but anytime I've been given morphine via IV it just doesn't help with my pain so I'd be afraid that MSContin wouldn't work for me either.

Another thing...would it be unreasonable for me to ask my PM doc for a BT pain med that actually works for me? The Tramadol just doesn't relieve any pain at all anymore.

Sorry, I got sidetracked...Back to my main question and reason for making this post. Does anyone know if Illinois Medicaid would cover the fentanyl patches changing every 48 hours...so 3 boxes per month instead of 2? If not, does anyone know of a way I could find that out before my PM appointment?

Thanks everyone!

Good day Mark.

Just my opinion as a patient on tramadol for years - I don't consider tramadol much of a "breakthrough" med. I like it on a regular basis because it increases serotonin, which makes me happier, but it's not a great pain-reliever, about like 2 or 3 Advil.

Since you have tumors, aka cancer, your doc can probably prescribe just about anything for pain. If he increases fentanyl and the reason cancer on the script, I'd guess it would be approved. I couldn't get Lyrica to try for nerve pain until my doc put fibromyalgia, which I really do have, on the script. And then it didn't do anything for me.

Morphine - you could be one of the people, like me, who don't get pain relief from it. I was given it IV when I had a heart attack and later for spinal anesthetic and it didn't feel like I'd had anything at all, zero, no side effects even. It didn't work for my mom either. It's not that unusual. MS contin is just morphine controlled release, so that's unlikely to work. Funny though, I get very good relief from Dilaudid. You might ask about trying that for breakthrough.