Cost of Hyperhidrosis Treatments and Insurance Coverage

If you suffer from hyperhidrosis, medical costs and insurance coverage are major concerns. Here is a break down of all of the most common hyperhidrosis treatments, their estimated costs, and whether or not they are covered by insurance.
Cost of Hyperhidrosis Treatments and Insurance Coverage

Hyperhidrosis costs (robs) its sufferers in many ways, not the least of which is via financial burden. The treatment options available to those with primary focal hyperhidrosis can often be expensive, invasive and time consuming. It is important for patients to understand the financial costs of potential treatment options so they can make informed decisions about their health care. There is a cost to benefit analysis that each patient must make when deciding on a treatment plan of action. In order to do this they need access to information about the real-life cost of each treatment, and an understanding of how insurance will or will not cover it. Below is a break down of the most common treatment options for hyperhidrosis and the costs patients can expect when choosing to manage their hyperhidrosis with a doctor.

The type of treatment a particular patient needs depends on the body parts most affected by their specific case of hyperhidrosis. This article will discuss the costs of specific treatment options available to those who have craniofacial, palmar, plantar and axillary hyperhidrosis.

Each section below will list the body areas each treatment is available for, it’s monetary cost, whether it is covered by insurance, and the amount of time it will generally take.

Over-the-Counter Topical Treatments

Over-the-counter topical treatments for hyperhidrosis which typically contain the ingredient Aluminum Chloride are recommended as a first-line treatment for craniofacial, palmoplantar and axillary sweating. Regular antiperspirants, even when marketed for other areas of the body, are safe to use on the face and scalp, although they may cause minor irritation, and there are even antiperspirants for the face and groin that can be used on sensitive skin.[1][8] There are various types of topical treatments ranging from cremes to wipes. Here are some examples of the products available and their prices. None of these treatments are covered by insurance as they are over-the-counter treatments and do not require a doctor’s authorization to use.

  • Treatment can be used for: craniofacial, palmar, plantar and axillary sweating.[8]
  • Cost: Depends on the brand, ingredients, strength chosen and length of time it lasts; prices range from:
    • Carpe: $14.95 for a 40 mL bottle; 15% aluminum sesquichlorohydrate with 85% moisturizing cream; lasts four to seven weeks[4]
    • Certain Dri Prescription Strength: $8.86 for a 35.5 mL package; 12% aluminum chloride and 88% moisturizing and anti-irritating solutions; lasts five to six weeks[2]
    • Sweat Block: $19.99 for a box of eight wipes; 14% aluminum chloride solution paired with 86% moisturizing compounds and inactive ingredients; lasts four to seven weeks[16]
  • Insurance Coverage: Not covered by insurance.
  • Time it takes: Depends on the individual products. Some products need to be applied several times a day, while others only need to be applied every couple of days. It does not take long to acquire these products as they can be purchased online or at a drugstore.[2][4][16]

Prescription Strength Topical Treatments

Most clinical strength OTC products have been found to be superior to prescription products. This section will specifically focus on one treatment, called topical glycopyrrolate, which is only available by prescription. It needs to be noted that this formulation in not commercially available in the US, but it can be made at a compounding pharmacy. [15] There is a new type of wipe which also uses topical glycopyrrolate, called Qbrexza, which was just approved by the FDA.[17]

  • Treatment can be used for: craniofacial, palmar, plantar, axillary and all over sweating[15]
  • Cost: Glycopyrrolate cream - depends on compounding pharmacy; Qbrexza - information unavailable until October of 2018[17]
  • Insurance: Most likely. Due to the fact that glycopyrrolate cream must be compounded it may depend on insurers, although doctors can prescribe it[15]. Qbrexza is a very new medication so a generic form will not be available for some time, however insurance should cover a percentage of the cost once it becomes available in October.[17]
  • Time it takes: These medications are usually applied once daily and may take about a week to show full effectiveness.[15][17]

Oral Medications

Several prescription oral medications can be used for hyperhidrosis and the management of its symptoms. This section will focus on the cost of the most common type of medication used to treat the condition. Theses medications are called Glycopyrrolate and Oxybutynin which are anticholinergics, and clonidine which is an alpha-adrenergic agonist.[15] These are considered to be second line treatment option for palmar and plantar hyperhidrosis and a third line treatment for axillary hyperhidrosis.[8]

  • Treatment can be used for: craniofacial, palmar, plantar and axillary sweating.[8]
  • Cost: These are a general estimate of the cost of each medication. Actual prices will vary depending on insurance coverage and where medication is purchased.
    • Glycopyrrolate: $18.80 (60 tablets of 1 mg)[7]
    • Oxybutynin:$20.16 (60 tablets of 5 mg)[13]
    • Clonidine: $4.00 (60 tablets of .1 mg)[3]
  • Insurance: Yes, coverage amount will depend on individual plans and companies.[15]
  • Time it takes: Fairly quickly. Depends on the medication and the dosage prescribed.[15]

Iontophoresis

Iontophoresis is a treatment that uses a machine to pass an electrical current through trays of water (electrodes) in which a patient places their hands or feet. The electrical current pushes an ionized medication into the skin to treat hyperhidrosis. Iontophoresis is used for palmar and plantar hyperhidrosis treatment. It is considered a third line treatment.[15]

  • Treatment can be used for: Palmar and plantar hyperhidrosis[15]
  • Cost: There are two options available, to buy a machine at home or to have the procedure done at a doctor’s office. Usually, it is a good idea to have a doctor or trained medical professional demonstrate the procedure and then, if a patient feels comfortable, they can purchase a machine and continue treatment at home.
    • Doctor’s Office: Some sources have noted that each session at a doctor office can cost $150 but this varies greatly depending on location and individual practitioners.
    • At home: There are several reputable types of machines available. The R.A. Fischer and Hidrex USA machines are cleared by the FDA. It is important to understand that all of these medical devices require a prescription from a doctor. Another brand not listed below is Idrostar which also has a good reputation.[10]
      • R.A. Fischer machine: there are two types…
        • Analog model (MD-1a) that contains water bath trays is $675
        • Digital model (MD-2) has more features and is $975
          • With R.A. Fischer products there is a rent to buy program which costs about $100 to $150 per month.[10]
      • HIdrex: there are two models available…
        • DP450 Iontophoresis Device Package - $695
        • DVP1000 Iontophoresis Device Package - $950[9]
      • Idromed: There are two models available...
        • Idromed 5 PC - with Pulsed Current - $795.25
        • Hidrex PSP1000 - with Pulsed/Direct Current - $850.50[11]
  • Insurance Coverage: Yes, it is typically covered. The provider must indicate that the patient’s hyperhidrosis is a medical condition and not a cosmetic one. Most insurers will also reimburse patients for the cost of a iontophoresis machine. Coverage will vary based on insurance companies.[15]
  • Time it takes: Iontophoresis is a time consuming process. Each session can last between 15 and 40 minutes and they need to be done three times per week. It can take several weeks to achieve the desired dryness level. Once that has occured, treatments only need to be performed once a week to maintain results.[10]

Botox Injections

Botox injections use botulinum toxin to bind to a specific site within a cell which blocks the release of acetylcholine and therefore prevents the activation of sweat glands. Botox for axillary hyperhidrosis is FDA approved. Botox treatment for palmar and plantar hyperhidrosis is not currently FDA approved but it commonly used off-label as a successful treatment.[15]

  • Treatment can be used for: craniofacial, palmar, plantar and axillary sweating. It is considered a second line treatment for axillary sweating and a third line treatment for palmar and plantar sweating. It is less commonly used for craniofacial hyperhidrosis, but can be a viable treatment.[8]
  • Cost: For both underarms one treatment costs $1000 (without insurance). Prices will vary depending on the areas of the body being treated. This is a good estimate for what other areas may cost depending on surface area and the individual doctor.[14]
  • Insurance: Many times. Insurance companies will often cover axillary Botox injections. In many cases companies will cover the procedure for other areas of the body once other therapies have been tried and were deemed unsuccessful. It does depend on an individual’s plan and how a doctor files.[15]
  • Time it takes: Patients notice symptom improvement between two and four days after initial treatment but it can take up to two week for full effects to take place. Results last for four to twelve months before the procedure must be repeated.[14]

Endoscopic Thoracic Sympathectomy

Endoscopic thoracic sympathectomy is a type of surgery used to treat primary focal hyperhidrosis. It involves a surgical technique in which a surgeon disconnects the nerves that communicate to sweat glands by either using endoscopic resection, ablation or clipping of the nerves. This is a risky procedure and can come with some common and uncomfortable side effects like compensatory sweating. However, it is highly effective in preventing sweat in the areas targeted.[15]

  • Treatment can be used for: craniofacial sweating, palmar sweating and axillary sweating (it is most effectively used for palmar hyperhidrosis)[15]
  • Cost: Estimated between $10,000 and $20,000 (if not covered by insurance) With this surgery you also have to factor in the cost of anesthesia and medications needed for after surgery.[5]
  • Insurance: Most likely. Once all other treatment modalities have failed and depending on an individual’s insurance provider.[15]
  • Time it takes: It is an outpatient surgical procedure. Usually acute recovery takes between three and five days, but it takes longer to fully recover. Results are permanent, as are the side effects.[6]

MiraDry

MiraDry is a new medical device that destroys sweat cells by using microwaves. It is FDA approved for the treatment of axillary hyperhidrosis. It is one of the local permanent treatment options available for axillary hyperhidrosis.[15]

  • Treatment can be used for: Axillary sweating[12]
  • Cost: Around $3000 depending on location[12]
  • Insurance: Not covered by insurance[15]
  • Time it takes: The procedure lasts about an hour. Complete recovery is around five weeks. The procedure is permanent so sweating will not return. However, it may take some patients two treatments to get their desired results.[12]

It is important to understand the prices of treatment options so that money doesn’t cost someone their health in the long run. Besides just the prices of treatment, hyperhidrosis sufferers face the cost of buying specific types of clothes, the loss of opportunities at work and in their social life, and the loss of their mental health and time. This does not have to happen, as there are now adequate treatments options for this serious disorder. Hyperhidrosis is expensive but relief is worth it.

Sources
  1. Benson, R. A., Palin, R., Holt, P. J., & Loftus, I. M. (2013). Diagnosis and management of hyperhidrosis. British Medical Journal (Online), 347. doi:10.1136/bmj.f6800
  2. Certain Dri Inc. (n.d.). Certain Dri® is here for you. Retrieved August 30, 2018, from https://www.certaindri.com/
  3. Clonidine. (2018). Retrieved August 30, 2018, from https://www.goodrx.com/Clonidine?form=tablet&dosage=1mg&quantity=60&label_override=
  4. Clutch Inc. (n.d.). Antiperspirant for Sweaty Hands & Feet. Retrieved August 30, 2018, from https://www.carpelotion.com/
  5. Considering Endoscopic Thoracis Sympathectomy For Hyperhidrosis? (n.d.). Retrieved September 1, 2018, from https://hyperhidrosisnetwork.com/hyperhidrosis-surgery-cost/
  6. Endoscopic thoracic sympathectomy (ETS). (2003-2018). Retrieved September 1, 2018, from https://www.sweathelp.org/hyperhidrosis-treatments/ets-surgery.html
  7. Glycopyrrolate. (2018). Retrieved August 30, 2018, from https://www.goodrx.com/glycopyrrolate?form=tablet&dosage=1mg&quantity=60&label_override=
  8. Huddle, J. R. (2014). Hyperhidrosis: Causes, Treatment Options and Outcomes. New York, NY: Nova Science.
  9. Iontophoresis. (2015). Retrieved August 30, 2018, from https://www.hidrexusa.com/product-category/medical-devices/iontophoresis/
  10. Iontophoresis. (2003-2018). Retrieved August 30, 2018, from https://www.sweathelp.org/hyperhidrosis-treatments/iontophoresis.html
  11. Iontophoresis. (2018). Retrieved August 30, 2018, from https://www.sweating.com/iontophoresis.html
  12. MiraDry®. (2003-2018). Retrieved September 1, 2018, from https://www.sweathelp.org/hyperhidrosis-treatments/miradry.html
  13. Oxybutynin. (2018). Retrieved August 30, 2018, from https://www.goodrx.com/Oxybutynin?form=tablet&dosage=1mg&quantity=60&label_override=
  14. OnabotulinumtoxinA Injections (Botox®). (2003-2018). Retrieved August 30, 2018, from https://www.sweathelp.org/hyperhidrosis-treatments/botox.html
  15. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Philadelphia, PA: Elsevier.
  16. SweatBlock Inc. (n.d.). Stop Excessive Sweating and stay dry with Sweatblock! Retrieved August 30, 2018, from https://www.sweatblock.com/
  17. Sweaty Back, Groin, Etc. (2003-2018). Retrieved August 30, 2018, from https://www.sweathelp.org/where-do-you-sweat/other-sweating/back-groin-other.html
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