Provigil (modafinil) — Highmark

Shift Work Disorder (SWD)

Preferred products

age ≥ 18 years
Diagnosis of shift-work disorder (ICD-10: G47.26)
Member has excessive sleepiness or insomnia temporarily associated with recurring work schedule that overlaps usual time for sleep
Symptoms accompanied by reduction of total sleep time
Symptoms present for at least 3 months
Sleep log or actigraphy monitoring for at least 14 days including both work and free days
Sleep disturbance not better explained by another current sleep disorder, medical or neurological disorder, mental disorder, medication use, or substance use disorder
If request is for brand Provigil: therapeutic failure or intolerance to plan-preferred generic armodafinil AND generic modafinil
If request is for brand Nuvigil: therapeutic failure or intolerance to generic armodafinil AND generic modafinil

12 months