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Prescribed Provigil but insurance wont cover
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Prescribed Provigil but insurance wont cover

I have been prescribed Provigil for my fatigue and my insurance (state assistance) will not cover the cost. I asked the pharmacy how much it would be just to buy it and he said it cost 500.00 monthly. My question is if anyone knows of a prescription assistance program or an online pharmacy that I can get this medication for a cheaper price.
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Another suggestion would be to try Amantadine, which is quite cheap and likely to be covered for you. It helps many MS patients.

ess
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Ask for a prescription for Nuvigil instead.  Provigil is more expensive and I actually had more side effects with Provigil.  Nuvigil is the 2nd generation of Provigil and the manufacturer has lowered the price to get everyone "switched" before the patent on Provigil expires in 2011.  

For me, the difference between Nuvigil and Provigil was amazing.  Nuvigil gave me back my life.  Provigil let me leave the house but I had trouble functioning.  And since Provigil is "going away" it is tough to even get samples.  My insurance never approved Provigil but they have approved Nuvigil.  Cheers, Jules
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1125401_tn?1262902527
My insurance (Aetna) would cover Provigil (at high copay) but wouldnt cover Nuvigil for MS at all. I explained I had trialed both and the nuvigil worked better for me but they wouldnt budge !

Isabel
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429700_tn?1308011423
I have this problem every time my prescription runs out.  I call my doctor's office and explain to his nurses that I've been denied, and they get back with the insurance company and I'm approved for another 3 months.  The nurses that work for my doctor are terrific--if it wasn't for them, I'd be in a heap of trouble.

Sometimes it's just a matter of having the correct paperwork and the correct things checked.  Provigil is not an approved medicine for treating fatigue in MS; however, I am experiencing other problems besides fatigue and the nurse checked some of the other things on it (like depression, I think), and then it was approved.  

You have to jump through hoops sometimes--it's really pathetic what they make MS patients do to get what our doctors prescribe for us in good will.  

Best of luck,
Deb
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147426_tn?1317269232
My pharmacist told me to look to Canada and I found on online pharmacy that had decent prices.  It's still spendy, but later this year when I fall into the Medicare donut hole I will go to them.  I will give the site address by PM to anyone that asks.

Quix
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572651_tn?1333939396
Just a quick note - if you decide to order medicines online, make sure that you check out the pharmacy completely.  There are lots of scams on the internet willing to take your money and not send you pharmaceutical grade drugs in return.  You don't want to take something that is possibly harmful.

be smart,
Lulu
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Avatar_m_tn
My insurance wont cover Provigal or the generic. I have MS my Neuro said this might happen. It did... I have never been on anything for fatigue but need it NOW. What is the problem insurance has with this drug???
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572651_tn?1333939396
Hi, Swik1ct, it looks like you might be new here or I missed saying hello, so let me start by giving you a welcome!

The use of provigil/modafinil for MS fatigue is in the process of being studied and documented as an approved use for this drug.  It might have already happened, but until the FDA says a drug is useful for a condition, a drug would be considered 'off label' use.  

In the case of Modafinil, which I do take, it is approved for people with sleep disorders, particularly people who forms of narcolepsy due to the hours they keep/work.  

It is a somewhat controlled substance and I have to get my rx renewed every 6 months by the doctor and not yearly like most of my drugs.  I had a sleep study done, which shows I have sleep apnea, and that is why my insurance approved it for me.

Other people here have various stories, but we have heard a lot of rejections for provigil and its sister nuvigil.

Your neuro might consider other drugs - I know that ADD drugs such as Ritalin are sometimes tried.  Good luck and welcome again, Laura
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Avatar_m_tn
I understand that this community isn't intended for discussions about my illness, but since you all seem familiar with Provigil, I thought that I would ask. I have a treatment resistant form of depression that has not responded to numerous traditional antidepressant medications, although I have tried many. I was finally referred to a top research university to consult with a doctor who specializes in treatment resistant depression (TRD - an appropriate acronym if ever there was one). He has done many clinical studies treating TRD with Provigil (as have other research hospitals) and it is one of the few medications that has helped me. The problem is that my insurance company refuses to cover the medication, which is $2400 out of pocket for the generic form. I just cannot afford to pay $29,000 a year for medication. I started by calling the pharmaceutical company to inquire about assistance, but they have canceled their Provigil assistance program and also told me that depression is one of the few illnesses for which they do not provide assistance anyway. I then looked into other assistance programs, but they require enrollees to be without insurance, and giving up my health insurance is just not practical. So I then considered drug discount cards and the best deal I could find was a 10% discount, a cost that is still too prohibitive. So I am left with the real possibility of either using what little savings I have to cover this medication, until my savings are exhausted, or to go without one of the only medications I've found that helps me. Has anyone found any other creative ways to cover the cost of this medication? I do not know what to do at this point.
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198419_tn?1360245956
Hi Micheal - thank you for acknowledging your question is not related to MS, but that you just want some thoughts regarding what to do about how to get the med when insurance won't cover it.

Honestly, I have no clue why insurance companies out of the seemingly clear blue stopped covering Provigil - it's helped so many people that I know. It's absurd to say the least - but I'll not go there. What I do know is that doctors have offered Nuvigil (sp?) in it's place. It's a supposed sister med to provigil (from what I remember of the convo w/my neuro).  Perhaps you can ask your doctor about that.

I hope some others come along and see your post. This is an old discussion that you found here - one I've not seen in awhile. Wishing you the absolute best with find the combo of meds that help you ;) - shell
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1045086_tn?1332130022
Have any of your docs considered the possibility that your depression might be related to a sleep disorder (or two)?  There are quite a few types and you can be sleep deprived even if you feel like you sleep soundly all night.  

I think I remember depression being linked to OSA (obstructive sleep apnea) but insufficient amounts of REM sleep would also seem a likely culprit.  In either case it’s possible some of the drugs used to treat depression could actually worsen a sleep disorder and send a person into a vicious spiral.

Of course I have no idea if this is might be contributing to your depression but wouldn’t it be great if something like CPAP would be as beneficial as a drug AND be cheaper in the final cost calculations?  Plus, if you end up having a sleep disorder that is responsive to Provigil (or Nuvigil) treatment, the drug would be prescribed by the sleep specialist who diagnoses and treats the condition.  I would think insurance would be more willing to fill a script for this expensive drug if it’s prescribed for an FDA approved indication - rather than what they would otherwise determine to be marginal off-label use.

In my experience sleep specialists are usually neurologists but some are also in the fields of allergy and pumonology or are ENTs.  At least one detailed sleep study is required to diagnose.  They are expensive but your insurance will likely cover at least part of the cost.  It isn’t an overnight process but it might be a decent option considering your present dilemma.  Heck, it could even offer the potential of treating the underlying cause of your depression rather than simply taking aim at symptoms.  That would be a huge plus in my mind.  

Hope this helps something.  Good luck and please come back and let us know whatever solution you find that works.
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5212540_tn?1365197443
Provigil is approved for narcolepsy and idiopathic hyper-somnolence.  My neuro wrote a letter stating that I suffered from the latter.  It was covered for several years, then I switched to Nuvigil.  A few months later, my insurance stopped covering either one.  Since it hadn't been helping me very much, I just stopped taking it.
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