GENERIC Provigil Now Available (OT?)

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*Do NOT start, stop, or change any medication without discussing it with your

doctor, pharmacist, or other qualified healthcare professional.

Over the years, there have been countless members who were unable to get

Provigil or Nuvigil because of the high cost. Either they were uninsured, the

insurance refused to cover it, or they did their best to keep it out of reach by

placing it on the highest possible cost sharing tier (usually non-preferred

brand) or even by classifying it as a Specialty drug (Medicare Part D, 33.3%

coinsurance).

The good news is that Teva has released modafinil 100mg and modafinil

200mg. They are authorized generics produced by Cephalon (manufacturer of

Provigil and Nuvigil), which means it is identical to the name brand (same

active ingredients, same inactive ingredients, same fillers, same ink). The

packaging and writing on an authorized generic is usually different, but the

main difference is the lower cost, especially for insured patients (my

mother-in-law paid up to 22 times as much for brand than generic, regardless of

actual cost; my mother 20 times (private policy through BlueShield), my father

30 times with his last job, 12x when he had BlueCross at the job before that).

Nuvigil was released as a patent extender. *Provigil actually contains

Nuvigil. Armodafinil (Nuvigil) Armodafinil is an enantiopure drug

consisting of just the active (-)-®- enantiomer of the racemic drug

modafinil (Provigil). If modafinil looks like this (d and d is inactive,

armodafinil is ( b ). Even though these drugs are extremely similar and most

people can switch between the two without noticing a thing, some people cannot

tolerate one, but do well on the other.

It you take Provigil, you should ask your pharmacist to order modafinil

(sometimes they will continue to fill the prescriptions with the brand (higher

profit margin) for several months, until insurance refuses to pay for brand). If

you have a prior authorization, most insurance companies will not enforce

mandatory generic substitution until your PA is renewed (typically every 3, 6,

12, 24, or 60 months. Also, the pharmacy or you may need to call your pharmacy

benefit manager to have them update your authorization to include the new NDC

number.

If you take Nuvigil and generics are cheaper for you (sometimes Nuvigil has a

copay relief card that makes it cheaper than some people's generic copay;

Medicare, Medicaid, Tricare, and CHIP recipients not eligible) and want to

reduce your expenses, talk to your doctor (CRNP, PA-C, or other prescriber)

about whether or not modafinil (Provigil) would be appropriate for you. If you

don't want to wait for your next appointment, most doctors will handle simple

things like this over the phone and then call or fax the prescription to the

pharmacy of your choice.

Steve M in PA

*Do NOT start, stop, or change any medication without discussing it with your

doctor, pharmacist, or other qualified healthcare professional.