Provigil shock!

So Ive had some severe fatigue days lately and my doctor wrote me for provigil !

My neighbor, a pharmacist assured me I was on the correct path, I felt it to be the right path!

So I went back to pick it up at my pharmacy the next day.....yesterday and.....

NINE HUNDRED AND FOURTY DOLLARS for a 30 day supply!!!
(my insurance co had decided NOT to cover it-I get generics for 10 dollars)
Yes this was THE generic!

and this was after the pharmacy applied their discount trying to help me

I was in shock

Ive never seen a medicine cost as much as my mortgage!

I dont know what to do and am open to suggestion

I wont qualify for help, as I make a nice living
but I can't afford 1000 dollars a month

anyone else been here or have any ideas??

Check with your insurance company, they may have additional requirements. For mine I have to be on CPAP for 12 weeks (compliant) with no improvement, then they will cover the Provigil at the normal rate.

I appear to have sleep on-set REM, waves of grog during the day and I discussed this with my sleep doc. He said I may have mild narcolepsy and he could prescribe such meds for me but he said they are very expensive and insurance companies are fighting paying for them, so we decided to skip it for now. Thanks to you I now know what he meant by EXPENSIVE! Instead I take a few low doses of pseudo-ephedrine and some caffeine during the day to push off the grog.

Ask your doc if he has any samples you could try. You might find that Provigil is not for you anyway. Most drug companies keep the docs stocked with samples of drugs hoping that patients will like them and then buy them after samples are gone. I existed on samples for four years when one of my drugs was $450 per month (I had no drug coverage then--before Part D era under Medicare). My doc was very sympathetic of my situation and gave me samples every visit so I didn't have to buy any at the pharmacy.

It took me the original denial and two appeals with documentation from two doctors to get Blue Cross to cover my Nuvigil.

As a side note, Provigil just went generic, and for another couple of months there is only one company that has the right to produce the generic. So both the original maker and the generic maker are trying to milk all the cash they can out of this stuff. The price to drop a lot when more companies hit the market with their generic versions. In many cases Nuvigil is cheaper than generic Nuvigil right now.

VikingGnome wrote:Ask your doc if he has any samples you could try. You might find that Provigil is not for you anyway.

I prefer avoiding any drugs that involve the central nervous system anyway. The only risk using pseudo-ephedrine for me is that I have high blood pressure, but it is treated pretty well, so I monitor and if my BP is high, I cut back or skip the dosage and live with the grog for the day.

I vote you ask for samples first; then fight the insurance if they work.
Otherwise try something else.
I did that with my off-formulary Lumigan--my co-pay was so high,
I asked for samples from my optometrist, too.
He gave me 6 months worth.

If you can't afford then don't take it. Tell your pharmacist that it's beyond your means and you don't want it. Then work with your insurance company to find out what you have to do to get them to pay for it. If your paying for it out right he'll just cancel it and put it back in stock.

UPDATE

I called Blue Cross to find out exactly why they won't cover this
(as my doctor simultaneously was dictating an appeal letter for Provigil)

BC said they WOULD Cover NUVIGIL (with a 50 dollar copay)
IF my doctor goes through some type of formality and call in the new drug RX

all on Monday now of course, but in the nick of time for
my vacation which starts Tue

I guess this is a happy ending story, but it really opened my eyes
to the Shennaigans the drug cos play (at our expense)!

It leaves me with a nauesea over the whole deal

What IF this was a life and death drug?
It could be when I drive!

Many more drugs than ever are being non covered I learned
and the docs office said they fight these battles every day

Me: I fault the manufacturers pure greed.. not the ins
co as much

Opened MY eyes (while trying to keep them open!)

Not just the manufactures,
but the lawyers too and end general people....

Ever see those comercails on TV? The ones for the drug for this and that? Then a year or so later, you see another comercial put up by some lawyer trying to sue said drug company for money and get more people to sue.

I can see where ya, if the drug is dangerous it should be taken off the market,
But I get the imrpession that these side effects that tehy are sueing fore are so general and vague that you can't positivily link them to said drug, or if you do, it was in the disclaimer in the orignal comercail. But, these lawyers and people keeps sueing the pharmicudicla companies... wich results in them having to raise their prices to cover the cost of lawsuist... It's a sad vicious circle

PS

I think I left out the part about where I learned the manufacturer, just before the patent expired, bought out all the cos that wanted to market the generic! Hence the generic was insane$$$ and the BRAND of NUVIGIL (similar drug) is now cheaper than generic Provigil...thus my insurance company was painfuly trying to steer me to "NU" Vs "Pro" !

Games


all games

over $$

Try dealing with this, fatigue, AND the airlines and THEIR money games all at one sitting

you go nuts

fredboy wrote:...What IF this was a life and death drug?... I fault the manufacturers pure greed..

That is often a different situation. My mother has some sort of cardio-pulmonary hypertension that requires a very specific and expensive drug... about $40,000 per year. She cannot afford this, and I don't think Medicare pays, so she gets a $2000 grant from somewhere and the "greedy manufacturer" EATS the cost and gives it her for FREE (well, for the $2000/yr grant). She pays zero. Good thing. It keeps her alive.

FYI. Drug manufacturers are not necessarily greedy when it comes down to life and death situations.

fredboy wrote:NINE HUNDRED AND FOURTY DOLLARS for a 30 day supply!!! (my insurance co had decided NOT to cover it-I get generics for 10 dollars) Yes this was THE generic!

Actually, I don't think so you were offered a generic. I did some checking around. Apparently, today, there was a court decision do allow Mylan to market a generic for Provigil beginning on August 10. The patents for Provigil don't expire until 2015.

Be sure and write your congresscritters to complain about being ripped off by drug companies. There is no excuse for them being allowed to charge what they charge for drugs.

fredboy wrote:BC said they WOULD Cover NUVIGIL (with a 50 dollar copay)
IF my doctor goes through some type of formality and call in the new drug RX

I have Federal Blue Cross/ Blue Shield and every year my Doctor has to call them and authorize my use of Celebrex and Nexium even though I've been using them for years. Just another hoop they want to run you through.