Migraine headaches themselves are a lot to manage, but if you need treatment for them, you’ll need to keep a close eye on your bank balance as well. Especially if your migraines are chronic (happen often).
One study found the cost of medical treatment for Americans with migraine averages $6,575 a year. That doesn’t include indirect costs like missed workdays. Even with good health insurance, such a price tag needs your attention and planning as you start treatment for chronic migraine. It will be easier to get relief from headaches if you don’t worry about money at the same time.
Your Diagnosis
Your general practitioner doctor may be able to diagnose migraine. So, your care and bills start with a doctor’s office visit. While costs may vary around the country, the average cost for one visit is $130 to $180 for an adult without insurance, or around a $30 copay if you are insured. Your doctor may refer you instead to a specialist called a neurologist for diagnosis. Online, neurologist office visits are typically priced at $200 to $400 before insurance.
After asking about your symptoms and medical history, and completing examinations, your doctor may order certain tests to rule out other conditions than migraine. These may include:
- Blood tests. One type of blood test sometimes used to help diagnose headaches is erythrocyte sedimentation rate (ESR). Online, ESR tests typically are priced between $30 and $50. You may have a copay if you have private insurance, but Medicare covers 100% of blood tests your doctor orders.
- A magnetic resonance imaging (MRI) scan of your brain. A brain MRI can be priced anywhere from $1,000 to $5,000. As with other brain scans, your insurance should cover the cost, but you will be responsible for meeting a deductible and copay.
- A computerized tomography (CT) scan of your brain. Online, CT scans are priced anywhere from a few hundred dollars to as much as $9,000, depending on where you live.
- An electroencephalogram (EEG) to rule out seizures. Prices found online range from $1,000 to $3,000, depending on the state.
Medications You May Take
Over-the-counter medications like Excedrin Pain, Advil Migraine, and Motrin Migraine Pain can relieve episodic (more occasional) migraine. But when it comes to chronic migraine, your doctor probably will prescribe one or more medications that either ease symptoms or help you have less headaches.
Pain relievers often prescribed for migraine include:
- Triptans, which block pain pathways in your brain. Examples are naratriptan (Amerge), rizatriptan (Maxalt, Maxalt-MLT), sumatriptan (Imitrex, Tosymra), zolmitriptan (Zomig ZMT, Zomig), and These and other prescription medications should be covered by private insurance, Medicare, and Medicaid. However, a copay (typically 30%) will apply. And, if you don’t have insurance, you’ll need to cover the entire cost. That’s why you may want to shop online for the best price at competing pharmacies. The lowest prices found online, after applying discount coupons, were:
- $21.98 for naratriptan ($6.59 copay)
- $11.99 for rizatriptan ($3.60 copay)
- $10.99 for sumatriptan (meaning a $3.30 copay)
- $24.83 for zolmitriptan ($7.45 copay)
- Dihydroergotamine (D.H.E. 45, Migranal) nasal spray or injection. This is an expensive drug, with the best online price $745.99 ($223.80 copay).
- Lasmiditan (Reyvow) tablets. This is another costly medication, with an online search turning up a $661.28 price ($198.38 copay).
- CGRP antagonists for acute migraine. Examples are rimegepant (Nurtec ODT) and ubrogepant (Ubrelvy) tablets. The best prices found for ubrogepant and rimegepant were each $875.61, or a $262.68 copay. The CGRP atogepant (Qutipa) is approved for prevention of migraines and its cost is $991
- Anti-nausea drugs such as chlorpromazine (Largactil, Thorazine), metoclopramide (Reglan), or prochlorperazine (Compro). Low prices were:
- $36.22 for chlorpromazine ($10.87 copay)
- $4 for metoclopramine ($1.20 copay)
- $13.63 for prochlorperazine ($4.09 copay)
Drugs your doctor may prescribe to help prevent migraine may have been designed for another purpose. These include:
- Blood pressure medications like:
- Atenolol (Tenormin). It is available online for $4 ($1.20 copay).
- Metoprolol tartrate (Lopressor). You can find it for $8.60 ($2.58 copay).
- Nadolol (Corgard). The best price was $9.50 ($2.85 copay).
- Propranolol (Inderal, InnoPran XL). A standard 30-day supply (the same as with many of the following drugs) is priced online as low as $11.90 ($3.57 copay).
- Verapamil (Verelan). It can be found for $8.66 ($2.60 copay).
- Antidepressants including:
- Amitriptyline (Elavil). You can find it online for $4 ($1.20 copay).
- Nortriptyline (Pamelor). Again, the best price is $4, or a $1.20 copay).
- Doxepin (Quitaxon, Sinequan). A search turned up a $10.30 price ($3.09 copay).
- Seizure drugs such as valproate (Convulex, Depakote) and topiramate (Qudexy XR, Topamax). Low online prices were $5.85 for topiramate ($1.76) and $21.80 for valproate ($6.54 copay).
- Injections of onabotulinumtoxinA (Botox). The best online deal was $612.68 ($183.80 copay) for 100 injections.
- CGRP monoclonal antibodies. The Food and Drug Administration recently approved these medications specifically for migraine treatment and prevention. They are expensive:
- Eptinezumab-jjmr (Vyepti). The lowest price found was $1,497.58 ($449.27 copay).
- Erenumab-aooe (Aimovig). The best online price was $628.98 ($188.69 copay).
- Fremanezumab-vfrm (Ajovy). You can find it for $623.72 ($187.12 copay).
- Galcanezumab-gnlm (Emgality). This drug is not priced online.
Some Costs for Lifestyle Changes
Migraine treatment isn’t only about medication. Some recommended lifestyle adjustments like self-taught relaxation techniques, consistent sleeping and eating habits, and drinking plenty of fluids cost you nothing. If you join a gym to relax, one national chain charges a $39 start-up fee and $10 a month, meaning $159 for your first year and $120 per year after that. If you are a yoga fan, your gym may offer classes for free; if not, you could pay $10 to $25 per session at a local studio.
Turning to Alternative Medicine
Alternatives to traditional medicine may help with chronic migraine pain. One is acupuncture. Your doctor can refer you to a qualified local practitioner. Find out if your insurance plan covers acupuncture only for pain relief or also to help with migraine. The median U.S. out-of-pocket prices are $112 for a first session and $80 for each follow-up session, one study found.
A session of cognitive behavioral therapy to help reduce frustration with your condition may cost $100 or more per hour. Make sure your insurance plan covers psychotherapy; you also can ask if the therapist offers fees on a sliding scale.
Taking supplements of riboflavin (Vitamin B-2) sometimes helps reduce the frequency and severity of migraine headaches. An online search turned up a 100-count bottle of 100-milligram capsules for $3.87.
Dealing With Lost Work Time
Chronic migraine has other ways of reaching into your wallet. Some people with migraine must miss work when the attacks get too painful. One study found that Americans with migraine miss nine more workdays per year than the average person.
Say you earn $80,000 per year and have already used up all your vacation, sick, and personal days for the year. Nine days without pay would reduce your pre-tax income by about $2,769. That’s a steep price tag for just about anyone.
