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 |  | Doctor Visit: $10-$200+ |  | Prescription Treatment: $35-$200+ Per Month |  | Physical Therapy: $10-$350+ Per Session |
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Fibromyalgia is a common syndrome, particularly among women, that's characterized by long-term and widespread pain throughout the joints, muscles, tendons and other soft tissues. It has been linked to fatigue, irritable bowel syndrome, and problems with sleep, mood and memory. Though fibromyalgia is not fully understood, researchers suspect it may be triggered by abnormal pain responses in the brain, infection or trauma, among other possible causes. There's no cure, but medications[1] and lifestyle changes may help minimize symptoms.
Typical costs: | - Fibromyalgia sufferers seeking medical treatment would start with an office visit to a primary care physician, which is typically covered by health insurance. For insured patients, out-of-pocket costs typically consist of a copay of $10-$50 or more, or coinsurance of 10-50% or more. For uninsured patients, an office visit typically costs $50-$200 or more. If necessary, a primary care physician may refer the patient to a rheumatologist.
- Duloxetine (Cymbalta), pregabalin (Lyrica), and milnacipran (Savella) are approved specifically for the treatment of fibromyalgia. For patients not covered by health insurance, these can range in cost from nearly $90-$200 for a 30-day supply. For patients with health insurance, out-of-pocket costs will typically include a coinsurance of up to 20% or copay of $35. A doctor may also prescribe an antidepressant or anti-seizure drug to help ease pain or fatigue.
- In addition, a doctor may recommend over-the-counter aids such a Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen which cost about $5-$25, depending on the quantity and whether the patient buys a name brand or its generic equivalent.
- Physical therapy or cognitive behavioral therapy may help patients better cope with symptoms. For uninsured patients, physical therapy typically costs $50 -$350 or more per session, while a one-hour session of cognitive behavioral therapy typically starts at $125 and can cost more than $250. For insured patients, out-of-pocket costs for these therapies typically include a copay of $10 -$75 per session or coinsurance of 10%-50% or more.
Related articles: Annual Physical, Physical Therapy, Acupuncture, Health Insurance
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What should be included: | - During the office visit, a doctor will conduct a tender points exam, which looks for specific areas that are usually sensitive to the touch among fibromyalgia sufferers. To be diagnosed with fibromyalgia, a patient must have had at least three months of widespread pain and pain and tenderness in at least 11 of 18 specified areas, including the knees, lower back, neck, elbows and rib cage.
- There are currently no diagnostic laboratory tests for fibromyalgia, but a doctor may conduct blood, urine, or other tests to rule out other conditions.
Additional costs: | - Because many of the symptoms of fibromyalgia are similar to other disorders, patients may need to see several doctors before receiving a diagnosis.
- Some patients use alternative therapies such as acupuncture, which typically costs $75-$95 for an initial visit. However, it's been difficult for researchers to determine how well these therapies really work.
Discounts: | - Many specialists who offer cognitive behavioral therapy will use a sliding fee scale based on a patient's income to determine costs.
- Discount outlets such as Costco[2] and Walmart[3] often sell prescription and over-the-counter drugs at significant savings. Walmart, for example, has a prescription drug program[4] that includes certain generic drugs at commonly prescribed dosages.
- Many hospitals offer discounts of 30% of more to uninsured/cash-paying patients. At St. Joseph Hospital[5] in Orange, CA, for example, patients without health insurance may qualify for a 45% discount off billed charges. They'll also be offered an additional 10% discount if payment is made within 10 days of receiving a bill.
Shopping for fibromyalgia treatment: | - The American College of Rheumatology offers a list of assistance programs[6] for certain rheumatology-related drugs and has a directory of specialists[7] .
- Online fibromyalgia forums like Daily Strength[8] may offer support in coping with the condition.
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Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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External Resources: | - www.mayoclinic.com/health/fibromyalgia/DS00079/DSECTION=treatments-and-drugs
- www.costco.com/
- www.walmart.com/cp/pharmacy/5431
- www.walmart.com/cp/1078664
- www.sjo.org/For-Patients/Your-Hospital-Bill/Self-Pay-Discount-Program.aspx
- www.rheumatology.org/practice/clinical/patients/acrast.asp
- www.rheumatology.org/directory/geo.asp
- www.dailystrength.org/c/Fibromyalgia/support-group
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