Today I found out that my Medicare Part D insurance carrier has changed the drug Provigil from a tier two to a tier three drug. That means that instead of the $38 I paid last year, I now have to pay over $90. I am flabbergasted, especially since that drug is due to go generic next year.

Has anybody else had this happen to their Provigil Rx? Is there anything that is generic that can be used instead of Provigil? I simply can’t afford the $90, and I do qualify for state assistance, but it is no longer their enrollment period.

Dag nabit!

I would say something but it would be political in nature.

Can't help with your problem with Provigil.

It is not unusual for copays to change tiers. It is the insurance's way to force you to try Ritalin generic for example for the same purpose. (or amphetamine).

This link explains the complex issue of generic availability and
when it may occur now (delayed) in 2012.
http://en.wikipedia.org/wiki/Modafinil
(scroll down near the bottom).

ProVigil is horrendously overpriced...I mean really...for what you get. This inflated price is what is driving the tier change for you.

I have a heart murmur, so I can't take anything that'll over tax my heart. Provigil didn't change my BP a bit, but any form of amphetamine would. I'll have to check out Ritalin. I just got a new PCP this week. Looks like he's got his work cut out for him.

If you can prove this, then you may make a claim to your insurance and they may waive the extra cost.

Typically your doctor would have to fax data to them, etc.
Check with them for this procedure.

There is no guarantee that ProVigil will work for you however.
It can fail.

FYI

Yet another way we as consumers of a necessary prescription medication get bent over by the pharmaceutical companies...

there is more to the slimy story if you go to the NYT link posted above.

http://www.nytimes.com/2010/01/07/bu.../07jetlag.html

"Provigil will face generic competition in April 2012 under terms of an agreement Cephalon made with several generic drug manufacturers. The Federal Trade Commission has sued Cephalon, saying it paid off those generic manufacturers to delay the advent of competition.
Cephalon, which denies the charges, is trying to shift patients from Provigil, also known as modafinil, to the very similar but slightly longer-acting Nuvigil, or armodafinil. Nuvigil has patent protection until 2024, although generic drug companies are already moving to challenge those patents.
To get patients to shift, Cephalon has raised the wholesale price of Provigil to $13.60, from about $5.50 a pill five years ago, including a 29 percent increase in November. So Provigil is now 50 percent more expensive than Nuvigil."