Target/Placement
Trigeminal nerve (forehead)
Approved for
Acute and preventive for migraine
Rx
No
Cost*
Notes
Cefaly External trigeminal neurostimulation (eTNS)
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sugar, stevia
$389-$424, plus $25-$33 for 3 electrodes, ordered every 2-3 months
Possibly also helpful for light and sound sensitivity, nausea, and vomiting
Acute or Preventive
Rimegepant (Nurtec)
Both acute and preventive
Savings Program Availability
Eligible commercially insured patients can pay $0 per month. Coverage under Medicare and Medicaid varies.
Dosage
1 tablet every other day for prevention OR 1 tablet as needed for acute treatment, not to exceed 1 tablet in 24 hours
Delivery Method
Oral disintegrating tablet
Most Common Side Effects
Nausea, stomach pain, indigestion
gammaCore Noninvasive vagus nerve stimulation (nVNS)
HeadaTerm 2 Transcutaneous electrical nerve stimulation (TENS)
*Most U.S. insurers don’t include neuromodulation devices in their coverage plans; some device manufacturers offer patient assistant programs.
Vagus nerve (neck)
Yes
Acute and preventive for migraine and cluster headache; preventive for paroxysmal hemicrania and hemicrania continua
$200 a month for unlimited use
Possibly also helpful for nausea, vomiting, dizziness, vestibular migraine symptoms
Preventive for migraine
$130, plus $25 for 3 electrodes to last about one month, depending on use
A more budget-friendly version of Cefaly with fewer frills
Nerivio Remote electrical neuromodulation (REN)
Relivion Combined occipital nerve-trigeminal nerve stimulation (ON-TNS)
SAVI Dual Single-pulse transcranial magnetic stimulation (sTMS)
Nociceptive receptors; induces conditioned pain modulation (upper arm)
$49 for first device (18 treatments), $89 for refill devices
Recently approved for pediatric use ages 8+
Trigeminal nerves, occipital nerves (around the head)
Acute only for migraine
Initial fee of $150 for 60 days; can purchase for $650 thereafter; electrodes start at $15 for box of 10
Other possible uses are being studied for depression, insomnia, ADHD.
Outer layers of brain (back of head)
About $395 a month for unlimited treatments
The only neuromodulation device that uses magnetic pulses; no need for skin contact or electrodes.
Target/ Placement
* Most U.S. insurers don’t include neuromodulation devices in their coverage plans; some device manufacturers offer patient assistant programs.