Where can I get provogil for cheaper?
July 19, 2009 4:56 PM   Subscribe

Where can I get Provigil/Modafinil for cheaper?

So we've covered where to get Provigil or Alertec if you're in canada. We've covered Adrafinil as an alternative.

What about where to get Provigil that's cheaper than the US?

I've been taking provigil for years. It's an amazing medication.
Downside is that now that I'm back in the US, it's 400 dollars a month.

With Insurance. Which is a high deductible plan, but more importantly, that refuses to pay for it

Also, I do not qualify for any prescription assistance programs.

I tried half pills to make it last longer, but that sucked.

Is that the closest I'll get to "real" provigil for <400?

If I understand correctly, Modapro and Modalert (asian variants of Modafinil), don't work quite as well as full Modafinil...

Is Modiadol from Mexico in the same boat?

Am I missing another alternative?

I considered Adrafinil, but the liver problems are a red flag, especially considering that I'd need to take upwards of 600-800mg to give the same result as 200mg of Provigil..

I ordered some Modiadol from MedsMex already and tried one. It seemed to be okay, but I've only tested 1 dose.
posted by Lord_Pall to Health & Fitness (15 answers total) 7 users marked this as a favorite
If you're taking it off-label (i.e. for a condition that it's not officially sanctioned for), then your insurance company may refuse to pay for it. Why are you taking it, and where did you get the prescription?

I have a Blue Cross plan in Massachusetts, and I pay a much much more reasonable amount for it.

On preview: I thought you were asking why your insurance was charging you so much for it. On the off-chance that's actually what you were asking, I'm going to post this. Good luck.
posted by alms at 6:04 PM on July 19, 2009

Response by poster: You seem to have mistaken this website for your doctor.

I've seen a doctor, have a prescription for an exorbitantly expensive medication. I'm trying to find out if there's a cheaper way to get it, either online or alternative formulation. (Modalert/whatever)

As for the costs and my insurance, It's for an off-label treatment (adhd), so even if I were to hit my big ole deductible, they still won't pay for it.

I'm just wondering if there's a formulation or pharmacy online that anyone here would recommend, or of the Modiadol from Mexico is my best bet..
posted by Lord_Pall at 6:17 PM on July 19, 2009

Could you hypothetically drive to Canada and buy, say, a year's worth at once?
posted by prunes at 6:26 PM on July 19, 2009

I think what one_bean means is that you should ask your doctor about a cheaper alternative - your doctor is there to help you navigate all the aspects of our health care system to make sure you get the care you need. You can probably ask over the phone, and won't even have to go into the office.
posted by awesomebrad at 6:29 PM on July 19, 2009

My impression from shopping around during my pre-prescription days was that there were tons of places online willing to sell it to you for reasonably cheap (something like $1/pill or so), but only if you faxed them your prescription. Since you have a prescription, this might be the way to go. Just search around for online pharmacies, and there are probably forums or websites that review such pharmacies to avoid the shady ones.

Hey look, "Related Questions" has some stuff about online pharmacies, dunno, maybe those will be helpful.

I would like to take this opportunity to be thankful for student health insurance. 90 pills/$20 is awesome.
posted by Jacen Solo at 6:38 PM on July 19, 2009

Response by poster: Ah.

Unfortunately, Provigil/Modafinil is sort of a class of it's own. You can't really get an approximation of it, save for Adrafinil (mentioned above).

I've already talked through alternatives with my doctor, hence the questions..
posted by Lord_Pall at 6:41 PM on July 19, 2009

> your doctor is there to help you navigate all the aspects of our health care system to make sure you get the care you need

I don't think this is true, and assuming that it is will probably lead you astray. Many doctors are only vaguely aware of the price of the procedures and/or medicines they prescribe, especially after you figure in the arcana of the various insurance companies.
posted by IvyMike at 8:23 PM on July 19, 2009

Do make sure your insurance really, really won't cover it. You may need a physician pre-authorization (a special form your doctor fills out) or to jump through other such hoops. Since you're taking it for ADHD, they'll probably claim that it's an "experimental" use and therefore not covered. You may be able to submit appropriate documentation from the professional literature (e.g. clinical studies) and get them to pay for it. Since Cephalon attempted to get FDA approval for modafinil as an ADHD treatment, there ought to be pretty good evidence out there (they ultimately declined to pursue approval due to the rare, but serious, side effect of Stevens-Johnson Syndrome, which you probably would have already gotten by now if you were going to get it). A PubMed shows a number of such studies. Submitting an appeal with this documentation and a letter from your doctor might just get you covered. As I understand it, "experimental" use of drugs is not covered by insurance, but not all off-label use is experimental.

Your high deductible is a drag, but at $400/month you'd probably hit it eventually, should you be successful in convincing your insurance company to cover it.

Finally, it's my understanding that Cephalon jacked up the price on Provigil to get patients to switch to Nuvigil, the longer-lasting enantiomer of modafinil. You might want to have the pharmacy price out Nuvigil for you, as it may be cheaper, and I can't imagine why your doc wouldn't let you switch. They are essentially the same drug--but Provigil is going off-patent in a year or two.
posted by zachlipton at 8:59 PM on July 19, 2009

I'm confused as to why your insurance company knows WHY you're taking it at all? My experience with medications is that I have a private doctor's appointment, the contents of which my insurance company is not privy to, and then I am given a prescription for a medication that says what medication I'm to get and how much. I haven't taken provigil, but I have taken other meds for off-label reasons, and I don't know why my insurance company would have ever known that. What am I missing?

If they do know, have you asked your doctor if they can help you write your prescription in a way the insurance company will accept? My doctors have always been very accommodating about the fact that insurance companies are picky about the exact wording on the paper, including one time that it had to be re-written 4 times before my insurance company would actually pay for it how my doctor wanted me to take it.
posted by brainmouse at 9:45 PM on July 19, 2009

Response by poster: Insurance already declined it, even after going through a few different support routes. Pre-auth, Medical Records, letters from the Doc, etc.

I filed a full grievance as well. Also declined. Basically, I followed through with all of the forms and claims, but because it's off-label, it's a no-go. MOre specifically, expensive off-label..

Cephalon most definitely raised the price to to cause people to switch.

Provigil has gone up 74% in the past 4 years.

My doctor is happy to prescribe Nuvigil, but if I recall correctly, it was only a few dollars less, hence the questions about the other formulations.

It seems more likely that the medmex Modiadol is going to be my best choice..
posted by Lord_Pall at 9:49 PM on July 19, 2009

Response by poster: Nuvigil is around 300 dollars for 30 days. There is a promotion where you can get a 50 dollar coupon, but I think it's for copays.

It's still over twice the price of the other formulations that I was asking about.
posted by Lord_Pall at 9:52 PM on July 19, 2009

Do keep fighting with them while you pursue other options. A formal appeal including copies of the relevant studies may be more successful. This article and others like it may be of use. You're often entitled to an appeal to an external review group as well. It might be useful to call up whoever authored your denial letter to try to get more information. You should also try calling the insurance regulator in your state for advice and potentially filing a complaint with them. There's fairly substantial evidence of effectiveness here. Good luck!
posted by zachlipton at 10:10 PM on July 19, 2009

but Provigil is going off-patent in a year or two.

WHOOOO HOOOOO HOOOOOOOOO!!!! Anybody got an exact date????
posted by exhilaration at 8:18 AM on July 20, 2009

Just buy Modalert online from Asia - it should be between $12-22 for 10 x 200mg tablets. Even if you are taking two a day, this should be no more than $150/month including shipping.
posted by turkeyphant at 5:58 PM on July 20, 2009

Response by poster: Do you find the Modalert better than the Modapro or Modiadol?
posted by Lord_Pall at 8:45 AM on July 21, 2009

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