gammaCore – Non-invasive Vagus Nerve Stimulator

What is gammaCore?

gammaCore is a non-drug treatment that provides non-invasive vagus nerve stimulation to help block the pain signals that cause migraine and cluster attacks. It has been cleared for adults living with migraine and cluster disease. 

How does gammaCore work?

gammaCore provides gentle electrical stimulation to the vagus nerve branches located on either side of the neck. The vagus nerve is the body’s superhighway for information transfer between the brain, internal organs and autonomic nervous system (1). Vagus nerve stimulation was originally intended to treat epilepsy, but the patients reported that the treatment had the unintended effect of reducing the frequency of their migraine attacks (2). Additional research has since been conducted and stimulation of the vagus nerve has been shown to reduce pain in humans (3) and animals (4). In rats vagus nerve stimulation decreased activity of the nerves involved in migraine pain (4). 

How do you use gammaCore? Acute vs. Preventative treatment

This information is sourced directly from gammaCore.com.

After applying the conductive gel, gammaCore is held against either side of the neck. The best way to find the appropriate location to stimulate is to use two fingers and find your pulse, and then apply the device just below that location. You know you are in the correct location when you feel a pulling sensation on the side of your lip.

Acute: 

• Use it at the first sign of an impending attack and give yourself a treatment consisting of 2 two-minute stimulations. 
• If pain remains 20 minuets after the first treatment, complete 2 more stimulations. 
• A final 2 stimulations can be applied if pain remains 2 hours after the start of treatment 1. 

Preventative / Daily:

• Give yourself 3 treatments (morning, mid-day, and night), each consisting of 2 two-minute stimulations 
• It’s recommended that the first treatment be applied within 1 hour of waking, the second 4-6 hours after the first, and the third applied at night. 
• Stimulations during a treatment should be applied to the same side of the neck, but you can switch to a different side on your next treatment. 

How can you get gammaCore?

GammaCore is available by prescription only . The enrollment form and the prescribing process can be found HERE. See the outlined steps below:

1. Click here and add gammaCore to your cart
2. Create a user ID and password
3. Order gammaCore options:
   • Option 1: Schedule a telehealth consult, which will prompt the consumer to GammaCore’s partner Vytal, will then have a licensed physician review the file on record and either text or call you with any questions for the consult (this doesn’t cost anything extra). If the physician reviewing the case deems gammaCore to be appropriate, they will send a prescription and the product will be shipped.
   • Option 2: you can have Vytal reach out to your doctor for a prescription. You will still create an account and fill out the questionnaire, but instead of a Vytal physician deciding whether or not gammaCore is right for you, Vytal will reach out to the physician provided and ask for a prescription.
     • Note: This is NOT recommended because it can take a lot longer for the doctor to respond, but it’s there as an option, if you want to use your doctor.
4. gammaCore ships to you! Your first shipment will include the gammaCore device itself preloaded with 93 days (3 months), the charging station, and the conductive gel. 
5. Refill: Each month or every three months you schedule the delivery of the prescription card and refill the same device in order to keep it operational. 

How much does gammaCore cost?

The out-of-pocket cost for the monthly refill card can vary depending on the clinical you are going to and the pharmacy that you are getting it from but it should be $150 for the first three months and then $200 per month after that.

Speak with your insurance provider about your coverage for medical devices and do not be afraid to appeal if you are initially declined. If you need help writing an appeal letter, CHAMP has a list of template appeal letters freely available to patients. 

References:

1. Babic, T., & Browning, K. N. (2014). The role of vagal neurocircuits in the regulation of nausea and vomiting. European journal of pharmacology, 722, 38-47.
2. Goadsby, P. J., Grosberg, B. M., Mauskop, A., Cady, R., & Simmons, K. A. (2014). Effect of noninvasive vagus nerve stimulation on acute migraine: an open-label pilot study. Cephalalgia, 34(12), 986-993.
3. Kirchner, A., Birklein, F., Stefan, H., & Handwerker, H. O. (2000). Left vagus nerve stimulation suppresses experimentally induced pain. Neurology, 55(8), 1167-1171.
4. Bohotin C, Scholsem M, Multon S, Martin D, Bohotin V, Schoenen J. Vagus nerve stimulation in awake rats reduces formalin-induced nociceptive behaviour and fos-immunoreactivity in trigeminal nucleus caudalis. Pain 2003; 101:3–12.