Migraine Headaches

Botox injections can effectively reduce chronic migraine, post-concussion and cervicogenic headaches.

 

Dr. Madhani is extensively trained and has over 5 years experience in the PREEMPT protocol for using Botox to treat chronic migraine headaches

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Medications approved for migraine

Neuromodulating drug Botox was approved by the U.S. Food and Drug Administration in 2010 for migraine treatment. Most insurance companies in Canada will only cover Botox. 

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Dysport, Xeomin and Mybloc are not approved for Migraine prevention but can be used off label if requested by the patient. This option requires more process and time for ordering medications.  If this option is chosen by patients it will require prepayment for medications and signed release for off label use. 

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How Does Botox Work to treat chronic migraines?

Botox works by blocking multiple pain pathways blocking many pain signaling pathways at ones where as other medications only focus on a single pathway. This is why it is more effective at chronic headache management. It also relaxes muscle triggers for migraine headache.

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How is it administered?

Small amounts of Botox are injected under the skin into selected areas of the head mirroring mapped out nerves involved in the development of migraine it also target neck and shoulder muscles. Injection pattern follows the PREMEPT Protocol.

 

The treatment itself takes less than 15 minutes and is repeated every 3 months.  After treatment the medication takes up to 10 days to become fully effective. 

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You need a minimum of 3 treatments to fully assess the effectiveness of Botox in treating your migraines or headaches.

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Botox Coverage

Most extended health insurance plans generally cover the cost of   Botox for chronic migraine.  Without insurance the cost of the medication can range from $600-800. Extended health plans typically do not cover the injection fee for the doctor to administer the medication unless your policy has provisions for a health spending account. The injection fee is paid to Dr. Madhani in advance of the injection and covers the cost to prepare the medication and administer the medication. Please refer to the Fees. 

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For coverage of medication costs most extended insurance plans require you experience more than 15 headache days per month and have failed a trial of two oral preventative agents (from 2 different medication classes), each taken for more than three months or stopped due to contraindications.

 

The percentage of drug cost coverage will depend on the provisions of your individual policy and require Dr. Madhani to complete insurance pre-authorization forms at initiation of treatment and at regular intervals afterwards. The completion of this paper work is not covered by MSP and is a private pay service.

 

Recording your headaches in Dr. Madhani’s Headache Diary will assist in completing this form and maximize the chance of continued approval for Botox.

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BC Pharmacare does not cover the cost of Botox injections for chronic migraine headaches, even with special authority. We encourage you to write to the Minister of Health to discuss this issue.

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Other Uses for Botox

Dr. Madhani is also trained to use Botox for cervical dystonia (torticollis), temporomandibular joint dysfunction, blepharospasm, trigeminal neuralgia, and some cases of thoracic outlet syndrome.

 

BC Pharmacare may cover the cost of Botox injections for dystonia, spasticity, and blepharospasm if a special authority is submitted and if you qualify for medication coverage through Pharmacare.