Financial Incentives to Choose One Medication Over Another: The Nuvigil Copay Program

Patient Expert

There I was this morning at the pharmacy with my mouth gaping open.   The pharmacist had said, "You just need to sign here.   There is no copay."

What?   I didn't owe anything?   That can't be right.

I knew that I needed to fulfill my insurance's $100 deductible for prescription medications for this calendar year.   I even had my credit card in hand ready to swipe through the card reader.     Ready to pay the big bucks to bring home my precious one-month supply of Nuvigil (which I take to combat MS-related fatigue on occasion).

"Why is that?   I know that I owe something," I said.

My pharmacist pulled out a brochure which included a plastic "Nuvigil Prescription Savings Card" from the pharmaceutical company.   It clearly advertises "co-pay as low as $5 on your prescription refills."   A footnote at the bottom of the front page states that this "offer [is] limited to insured patients only."   Limitations apply.

I am an insured patient, but my prescription coverage is limited to $1500 each year.   As a result, I carefully balance how I obtain my medications whether through mail-order programs for generic-only medications (which do not use my precious drug coverage) or through the local pharmacy when I quickly need an antibiotic or need to use a brand-name drug.

For my own knowledge, I asked the pharmacist, "So how much did my insurance company pay for this prescription?"   He couldn't tell me because after processing the Prescription Savings Card, the numbers were not visible in his system.

I signed the card reader for my $0 copay prescription and kindly thanked the pharmacist.   He handed me the small sack containing a 30-day supply of Nuvigil which is valued at $424, according to DestinationRX.

After I got in my car, I pulled out the brochure.   I had missed the big words - "Your First Prescription Free."   OOooohhhhhh.   So that's why I didn't owe anything" this month anyways.

What is going on is that Cephalon (a company which is now owned by TEVA, the same drug company which manufactures Copaxone) wants to keep its customers using their product.   Cephalon makes both Provigil (modafinil) and Nuvigil (armodafinil), closely related medications approved to treat excessive sleepiness associated with narcolepsy and other certain sleep disorders.

Provigil is finally going off patent in April 2012, according to FDANews (pdf), and will be facing generic competition soon.   Cephalon had basically paid off four other drug companies in 2007 to delay the introduction of generic versions of Provigil.   So now is the time to make sure that as many patients as possible have switched from Provigil to Nuvigil (which doesn't go off patent until 2023).

This push to switch patients to Nuvigil is not new; it has been going on for the past two years.   I have been using it because I could still get samples from my neurologist.   The price has also been kept at about half of what Provigil is billed to insurance.   Regardless of price or availability, any prescriptions I fill must be carefully balanced for cost/benefit.

After I returned home and was relaying my shock of not having to pay for my prescription, I said something which made my mother laugh.   I said"

"I never get anything, or qualify for anything, without having to work for it!!"

I laughed too.   I'm even smiling knowingly as I write and research this post.   Just go to the Provigil homepage and what do you see? "Ask your doctor about a free trial of Nuvigil (armodafinil) Tablets.   Learn more and save at"

Of course.   No wonder free medications are being offered.   This is about keeping people on a brand-name drug versus losing them to impending generic competition.

No matter the reason, I am thankful for saving just a bit more of my prescription drug coverage for this year.   I will be able to afford at least one more month of non-sleepy, non-fatigued, clear-thinking, fog-free multiple sclerosis living.

Thanks, TEVA.

Postscript:   Just a few minutes ago, I received a call from my pharmacy.   Apparently I left my credit card on the counter.   Can you believe that?   I literally forgot what I was doing when I was informed that I owed no money.   Honestly, I was befuddled.