grrrr.... I love/hate insurance companies :(

[Moosette]

ok so gonna rant for a minute on here I was given some samples of Nuvigil from my neuro and had begun taking them on days where fatigue was really bad (like, not getting out of bed all day bad). I have a little girl that I stay home with so, those days don't go so well for her or I. Anyway, insurance has been giving me the run around on filling a prescription and after an appeal they sent a letter that stated they still don't think my claim is a valid reason to cover this med....and yet they think something called "shift work disorder" is? correct me if I'm wrong but working nights isn't a disease is it? Or am I just not fully understanding what SWD means? So, thankfully my neuro is going to supply me with some more samples and is helping me out with trying to get some different meds...has anyone else had a nightmare-ish time trying to get a Nuvigil prescription? Also, if you are taking another drug that isn't nuvigil for fatigue, what is it and does it work for you? Thank you for listening!!!

[cranberrysauce]

OMG! I just googled that Shift Work Sleep Disorder and I'm as baffled as you!

I mean, obviously, due to our circadian rhythms it would be hard to be a shift worker and stay up at night but I can't believe an insurance company would cover a drug so people can work at night but not so a regular person can stay awake a lead a normal life/care for their child. I would argue having a kid is the equivalent of working rotating, often nighttime "shifts"

I'm so frustrated for you and just wanted to let you know I 100% see why you're so confused/annoyed.

[Redwings]

Many insurance companies control their drug costs by limiting coverage of expensive, brand-name drugs to only those conditions for which they're FDA approved. For Nuvigil, those uses are narcolepsy, obstructive sleep apnea and shift work disorder. The insurers aren't required to cover drugs for off-label uses, such as any brand-name drug for MS fatigue.

If the drug company wanted Nuvigil approved for MS fatigue, they would have gone through the process of having it approved, and they didn't. Trying to apply off-label-use logic to prove some kind of discrimination is pointless. Or, to quote John Mellencamp, don't confuse the problem with the issue.

It may not matter much, though, because Provigil, Nuvigil's sister drug and predecessor, goes generic in a couple of months.

[shellos8]

Moosette, I feel your pain. My insurance co. denied me Lyrica because I guess it's not approved for MS pain. Only fibromyalgia and diabetic neuropathy. What confused me is that I see online a lot of people who take Lyrica for their MS pain. So I wonder how they're getting it? Ugh, so frustrating. If I were you I would try to hold out for a couple of month like Redwings said, and try to get the generic Provigil. Have you tried Provigil?

Redwings, I'm so glad to hear Provigil goes generic soon. I need it, but simply cannot afford another $50 per month co-pay.

[Moosette]

thanks for the sympathy cranberry & shellos, I needed that ... because it is frustrating and unfair!! That being said (and my toddler tantrum now over), I knew about most of the reasoning behind why my insurance company didn't approve my rx and as redwings explained there will be a generic provigil coming out soon...I have not tried the provigil yet though, have any of you been on it? If so does it seem to work pretty well? Thanks again for the supportive responses, it means a lot