Insurance Turning Down Cymbalta Over 2 Years Of Taking It (Top voted first)

I was taking Cymbalta for depression and anxiety for two years. I also have chronic back problems, and it was helping my pain. Out of the blue, whatever the name of the government prescription plan for people disabled and on Medicare decides to stop paying for it and, therefore, allowing me to take it! I was switched BACK TO Effexor's generic, Venlafaxine XR, which wasn't working nearly as well as the Cymbalta. I know it's not just because I have government based insurance because other people pay for insurances that do that also. I just wish that whoever is benefiting from the profits of this would realize that the maybe 50%+ in income from old medications and dispensing generic medications, is not fair to the sick if they don't work. Mental Illness is a real disease. I have had cancer and beat it, 5 invasive surgeries and emotional tragedies in my life, and Mental Illness is still #1 in my book, after being disabled from it for 27 years, when it comes to the worst illness/problem I have ever had!

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Hello, Candy! How are you? I'm very sorry about the problem you've run into.

However, the best suggestion I can make in this situation is to discuss the problem with your doctor. If the Effexor doesn't work that well for you, then you may need to try a different medication.

What type of doctor have you been seeing? A specialist might have a better idea of what could help you and what your insurance may cover.

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Hi Verwon! Nice to hear from you. I know I can always count on you for answers. I am seeing a Psychiatrist. I also see a Neurologist because I have Temporal Lobe Epilepsy from a serious head injury. I have been disabled 27 years for the mental illness. Besides a host of other mental illnesses, I have TRD (treatment resistant depression). That is another reason my appeal had listed on it for the Cymbalta, plus helping my pain (later in this answer) to be necessary. I have had all the things associated with TRD--countless, maybe 50 trials of combinations of anti-depressants, mood elevators and anti-psychotics, 4 Electro Shock Treatments and I have the Vagus Nerve Stimulator implanted in my neck. Anyway, that was awhile ago that the Cymbalta was turned down and the Effexor took it's place. After three appeals, my Doctor and I were informed to stop contacting them about the same medication. Since then, as a last resort, (if you Google search TRD) it says this on the bottom of the page I read--my Psychiatrist gave me a stimulant. He tried me on Nuvigil, which worked great for the month the insurance paid for. Then it was turned down and the insurance suggested Provigil and I took that for one month with excellent results too. Then the insurance decided they weren't going to pay for that either! I know why! The price for 30 twenty mgs. pills is around $800 up to $1000 or more in the U.S., so my Doctor researched with me to find a place I could get the generic Modafinil overseas. I get 200 pills for about $200! However, it is not as effective so I have to take more, so in the U.S. I would have to multiply my dosage by $800+ per month! I know it is addictive. I also take up to 30 mgs. three times a day of Roxycodone for Degenerative Disc Disease, Sciatica, Lumbar Stenosis and Stenosis in my left leg, and Fibromialgia. I have been in recovery since1990 for alcohol and street drugs, but I have NEVER in four years now, taken more than my doctors prescribed. I go to a pain institute for my back, etc. and also have a portable TENS Unit like the Physical Therapy I go to on and off starts my sessions with. I am doing pretty good. One more thing that you may be wondering is legality of ordering medication overseas. I called the FDA at the time before I ordered my first "prescription" (they do not require a prescription to order it) of Modafinil, and was told that it is legal as long as my Doctor has it on record that he prescribed it and how much he prescribes. I hope the information here helped at least one reader in some way.

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