Provigil denied
Provigil or it’s generic Modafinil reduces extreme sleepiness due to narcolepsy and other sleep disorders, such as periods of stopped breathing during sleep (obstructive sleep apnea). It is also used to help you stay awake during work hours if you have a work schedule that keeps you from having a normal sleeproutine (shift work sleep disorder) https://www.webmd.com/drugs/2/drug-16964/provigil-oral/details
I’ve taken this drug for over 10 of my 21 years having MS. We decided to add it back in again recently because I’ve been suffering from fatigue Neurologist appointment complete.
I got a call yesterday from my prescription company that the request was denied. The denial was based on the FDA, Food and Drug Administration, does not see this drug to treat my condition, multiple sclerosis. It isn’t treating MS it is treating a symptom of MS. Ugh!!!!!!
So frustrating this bullsh@t you have to go through. My doctor has already sent over tons of paperwork including my long history with the drug. It even has a generic so this isn’t about money.
Provigil is considered a controlled substance which is why it needs approval but it is neither a narcotic substance or an addictive substance. What is the problem? How much information does a company need? I mean really, we never said we needed it to treat my MS, so annoying.
4 thoughts on “Provigil denied”
I have no doubt that you can make a case for using modafinil for MS. But, your insurance company is, technically, correct. Provigil (modafinil) is approved to treat narcolepsy but it was never approved specifically for MS. Even so, it’s been prescribed, off-label, for tens of thousands of MS patients. I’ve been using it for most of the 39 years since I was diagnosed. Currently, my Medicare Part D pays for my modafinil (with a co-pay). Since most insurance companies follow Medicare’s lead, I’d suggest that the information you send to your insurance people include the info that Medicare Part D approves it for MS and see what they say.
Ed
Considering that this was my part D that denied I’m glad you told me that. Im sure I need to appeal and we will win. I know the technical use for the drug. Is there any literature I could forward to them.
Yeah, I’ve had my battles too. The best one was when they approved one procedure then denied the same procedure 9 days later when more were requested. It took a couple of months to get that one taken care of. In our state we have something called the Healthcare Advocates office that help patients fight their battles, and it is a huge help. Hope you have something like that in your state
I don’t think we do but maybe. I usually fight myself and win…eventually. Just frustrating for both me and my doctors office