Cefaly® a Microcosm of what’s Wrong in Headache Treatment

The Cefaly® , if you are not familiar with it, is a device that delivers a very well controlled electrical stimulation to precise locations of the Trigeminal Nerve.  For decades (even centuries if you include acupuncture) we have know that if you stimulate painful nerve endings, they can respond by causing less pain. This could be the mechanism of acupuncture and for certain is the mechanism of TENs units.

The company behind Cefaly® worked for years to fine tune the device to deliver the optimal current and frequency for helping headaches. They completed several well-done studies and published the results in reputable, peer-review journals.  In conclusion, 50% of the patients using the device had at least a 20% reduction in the number of days of headaches. The company, which makes the Cefaly®, then took their studies to the FDA and were granted approval for migraine prevention. It is a very high bar to achieve this type of approval.

The Cefaly® is certainly not a migraine cure and doesn’t work for all sufferers, but it did help about half of the people who tried it. But it does help some and it is not medication, so it brings something new and valuable to the table.

The Cefaly® company then approached every insurance company in the US to get it covered. The basic device is $300 and electrodes are around another $50 for 90 days.  Every single insurance company in America, despite being shown the evidence, refused to pay for it. They all said it was “experimental” and therefore could not be covered.

In the past, the term “experimental” meant that there was no evidence that something worked so the insurance company did not feel obliged to pay for it. But the case of the Cefaly® is different.  It is NOT experimental and it has FDA approval.

The term “experimental” is a now a simple excuse for the insurance companies not to add anything to their list of covered treatments.  This especially applies to the non-drug treatments. By not adding new treatments they get to save money and increase profits.

Here is the great dis-service to the headache sufferer in particular.  A TENs unit, which works on the same principle as the Cefaly®, IS approved by insurance companies for use from the neck downward. But if you use it, or the Cefaly®, on the head, it is not covered. Why?  Simply because it has to do with headache and the insurance industry sees headache as insignificant.  More people are disabled from headache disorders than back pain, yet the headache sufferers face far more discrimination.

My point here is not just to promote the Cefaly®, but to look at the healthcare culture that stands in the way for headache suffers getting the treatment they need and deserve.