I have been reading on the investment websites that Teva and Mylan have reached an agreement in court over modafinil. Mylan will be selling a generic modafinil as of August 10. So now there are TWO pharms selling the generic. Maybe the cost will be coming down? I wonder if this means Medicare might be more inclined to cover the drug for MS-related fatigue.
-
-
Well this is good news. I did notice that since I fell into the dreaded donut hole, instead of paying $1200 for it, it was $235 for a 30 day supply. Maybe it will come down even more. -
I am so confused by this, Ellanor. I was so excited to getting Medicare and purchased a very good drug plan. All so I could get Provigil. My neuro submitted the script and the thing got denied. We were told that the FDA no longer approves this for MS-related fatigue. My neuro told me she has had over ten rejections for it this week. I am so happy for you that you are still getting it. I am going to try an appeal. Wish me luck.Comment
-
I have a Medicare Advantage plan...Bravo Health. My neuro has to get it approved, but they will cover it. I know how important this drug is to me and it makes me angry when I hear people can't get it. As it is, I have to take 1/2 of a dose to make it stretch.Comment
-
The FDA has never approved Provigil for MS-related fatigue; the manufacturer apparently never sought approval for that purpose. It sounds like it was Medicare that stopped coverage of Provigil for off-label uses. Hopefully, the price of the generic will come down enough that insurers won't be so quick to deny it for off-label uses.Originally posted by Tapdancer View PostComment
-
Its not just Medicare that doesn't approve it. I have Blue Care Network and after being on it for over 5 years they have denied it. It was the best thing that I ever tried.Webbles
Weebles wobble but they don't fall down (much)Comment
-
After being on Provigal for several yrs. I've now been denied approval for a refill. So not happy about fighting my insurance,as I'm also fighting for approval Gilenya. After a sever injection site reaction to my Rebif after 12yrs, my neuro wants Gilenya,Just can't win!!
nona JudyComment
-
I to am on medicare but thank God i was able to deny there drug plan cause i have tri care for life as being a combat vet .... its basically the same as medicare but i they dont deny me anything, heck they even flipped for a 175000 dollar plasmapherises bill when my blue cross/blueshield denied....Comment
-
I'm the wife of a combat vet.My husband was a 22yr.Army vet. I also have medicare & Tricare,just be prepared you never know when they will deny you something.Originally posted by lovejoy View Post
God Bless Nona JudyComment
-
provigil information
Hello,
I just signed up to reply to this post. I do not have MS but my Aunt does and I know how life is for her. I was researching Provigil. I was on it in the past and Bravo health made it harder to get. I went off it and I have not been the same since. Basically my last doc did not want to be bothered with the paperwork. So much for wanting to be in a helping profession right? I now have a great doctor and he is willing to help me battle Bravo. so I went into research mode and here's what I found. I tried to post a link but for some reason I cant but I found a Bravo form last dated 2011 which reads: All FDA- approved indications not otherwise exluded from part D. Coverage is provided for the off-label use of idiopathic hypersomnolence and depression associated with fatigue and/or sleepiness. The other side reads: Coverage is provided for depression associated with fatigue and/or sleepiness when the patient is receiving antidepressant therapy.
This looks like it is in the formulary but I have not found it in mine. It's on a document that lists all the meds that require pre-authorization.
If nothing is stated about MS why specify if they wont cover it for anything related to it? My aunt is getting put through the ringer as if MS is not a real disease. It really makes me mad and I hope I can help someone here at LEAST fight this crappy UN-surance company!!!
Basically this is why I was on it to begin with. I can't sleep and I have severe pain from Degenerative disc disease. the lack of sleep causes severe depression. I thought maybe if some of you could have your docs use the company's own wording it might help. I'm going to do it because provigil is a life saver for me and like I said...ever since I went off it I have been pretty much non-functioning.
Oh...there is also a SPECIFIC FORM that Bravo has for Provigil coverage determination. I don't trust them to send it to my doc so i am printing it out for him. I hope this helps someone. I really wish I could link to them. The specific form is a PDF and it is called Provigil Coverage DeterminationComment
-
Now, that scares me. I have been on it for quite awhile, as well, and I'm on Blue Care Traditional. They did cut back on how MUCH I could get (I had been taking large doses 2x/day by rx). I just decided (since I am getting over a flare, anyway, to cut them in half so I can rest better when I need to do so). I hope I don't lose this particular aid to managing my fatigue.Originally posted by webbles 989898 View PostComment
-
its kinda of funny but not, cause of having triple coverage with insurance i pay next to nothing for my drugs, but i see the cost of them my 30 day of provigal 200mg 3x a day costs 2100 which i pay 0 then since it went generic the bill sas it costs 3200. i still pay 0 but why does the generic cost more ? Pharma is big money its all about the politics involved, just read the other day that Betaserone does nothing for you.... how about a refund to all those who got dooped just sayingComment
-
It will be interesting to see how quickly after Aug. 10 the cost will start coming down. Doesn't help those of us whose scripts have been denied though.Comment
Comment