Provigil-Nuvigil

Drug - Provigil (modafinil) [Cephalon]
            Nuvigil (armodafinil) [Cephalon]

April 2012

Therapeutic area - narcolepsy

Brand Provigil is preferred over the generic equivalent.

Payment for Provigil or Nuvigil will be authorized if the recipient:

• Is at least 16 years of age AND 
• Has a diagnosis of narcolepsy OR 
• Has a diagnosis of Multiple Sclerosis and suffers from fatigue OR
• Has excessive sleepiness associated with obstructive sleep apnea AND is not also taking a drug to improve sleep (e.g., Ambien, Lunesta, Sonata, Rozerem) AND is compliant with CPAP therapy whenever possible OR
• Has excessive sleepiness associated with shift work sleep disorder and is employed

Nuvigil

• Nuvigil is marketed to be a once daily drug. There is a QL of one per day on Nuvigil. Quantities greater than 1 per day will NOT be approved

Provigil

• The Department requires tablet splitting for the 200 mg dose under the tablet splitting criteria. Both the 200 mg and 100 mg Provigil tablets are under PA restrictions. However, 100 mg tablets should be authorized only if the dose can’t be achieved using a 200 mg tablet

Provigil tablet splitting criteria

PA will be authorized if:

• Prescribed dose cannot be achieved using the appropriate higher-strength tablet, with instructions to split the tablet in half
• The recipient cannot understand the tablet splitting process
• The recipient has a mental health diagnosis that makes it dangerous for them to change the dose from a whole tablet to a half tablet, PA can be granted
• The recipient is simply unable to break a tablet in half, this is not an adequate reason to grant a prior authorization. The pharmacy or caregiver should be encouraged to break the tablet in half for the recipient

Products are subject to quantity limits, prior authorization and tablet splitting requirements. Generic modafinil requires prior authorization and Brand Preferred criteria must be met for authorization.

Questions?

MHCP Provider Call Center 651-431-2700 or 800-366-5411