Is Big Pharma learning its sales tactics from street drug dealers?

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Street drug dealers have used the same formula for years to push their product. They meet and sometimes befriend their target prospects. They offer them drugs for free or at a low price. They wait for their trap to spring — for the target to get hooked on the stuff. The end result is the perfect customer — one who will pay anything, or do anything, for their next hit.

Of course, this kind of marketing strategy isn’t high-toned enough to be covered in the Wall Street Journal — unless, that is, you’re Big Pharma pushing legal drugs.

According to the Journal:

Cephalon Inc. (CEPH) has launched a campaign to switch users of its best-selling drug, the stimulant Provigil, to a newer drug with longer patent protection, enticing patients with prescription co-pay assistance…

Nuvigil is chemically similar to Provigil, but Cephalon says its effects are longer-lasting than Provigil. The drugs weren’t tested head-to-head in clinical efficacy trials, but Cephalon says the drugs were compared in terms of concentrations in plasma.

From a business perspective, Nuvigil also has the benefit of patent protection through 2023. Provigil, approved in the U.S. in 1998, is due to face generic competition in the U.S. in 2012 under patent-litigation settlements Cephalon has reached with generics manufacturers. ..

Cephalon’s strategy is to switch as many Provigil patients to Nuvigil as possible to the mute the impact of Provigil’s loss of market exclusivity.

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The Journal adds that as part of its strategy, Cephalon has more than doubled the price of Provigil, so that now (with discounts and promotions) Nuvigil is cheaper.

Do you see what’s happening here? Let me break it down for you by way of analogy — in street terms.


A drug dealer — we’ll call him “MC Ceph” — has made a mint selling crack on his street corner. But now pimps like Rite-A, Wal-M and CVS-Dog are close to gaining access to a cheaper supplier and are planning to undercut MC Ceph’s price dramatically.

Wal-M is even talking about selling a 30-day supply for just $4.

MC Ceph would no longer be able to live large if this happened. He would have to settle for living medium-sized.

And how would it look to the Street if he didn’t keep increasing his revenues every quarter?

Now, MC Ceph is not the gat-toting type (he’s actually kind of a wimp), so he has to win this game with his wits. Fortunately for him, he figures out just the way to do it.

He decides to jack up the price he charges for crack while he still has no competition. After all, what choice do his crackhead customers have? He’s got a monopoly in the neighborhood.

Then, he’s going to start selling something he calls “nu-crack.” It’s really the same drug he’s always been selling; he’s just “cutting” it with different additives that change the texture and color of the drug.

He offers “nu-crack” for free or super-cheap at first — until his customer base gets hooked on it and is asking for “nu-crack” instead of old crack.

When the low-cost crack dealers arrive on the next corner, MC Ceph will have already converted his customer base — so he keeps his monopoly and his high margins.

There’s a risk in MC Ceph’s plan, of course. You see, “nu-crack” really isn’t much different from old crack, and if MC Ceph’s customers ever figure that out, they’ll be off to Wal-M — and he’ll be out of business.

And so it with Cephalon. Provigil is essentially the same drug as Nuvigil. Nuvigil was only created for marketing purposes, to retain Cephalon’s monopoly and its profits.

And so it goes — on the back streets, and on Wall Street.

About Cary Byrd

eDrugSearch founder, Cary Byrd, has been called an “e-health innovator” by MarketIntellNow, interviewed by top pharmaceutical industry journalists, invited to Matthew Holt’s Health 2.0 Conference and a Consumer Report's health summit, and highlighted on numerous health blogs.

Is Big Pharma learning its sales tactics from street drug dealers?

0 thoughts on “Is Big Pharma learning its sales tactics from street drug dealers?

  • So, I can’t belieive that, what about the people who were told this is going to work better for you since the 400mg of provigil isn’t cutting it anymore. Will we still be falling asleep at the wheel? Real nice, I will be searching for the cheap stuff when it comes out. Probly getting the stuff cheap from Cephalon anyway, then cheapening it up to get sales, and then Cephalon still wins. Grrr!!!

  • My doc recommended the Nuvigil lower dose first, then refills to 250mg 2 x day. Now that the free refill offers are expired I find out my insc wants $275 for 90 day supply. No way I can do that. Going to try Provigil next.
    Nuvigil gave me plenty of energy and I slept better at night. My mood swings weren’t nearly as destructive and I could be somewhat social and moderately in control.
    We’ll see what Provigil brings.

  • Well I guess my doc says only diff is nuvigil Is pure. I took 400 mg provigil for 2.5 yrs and I have one of the worst cases of idiopathic hypersomnia. It wasn’t working as good anymore so at checkup doc said try swiching to nuvigil. I did 4 days ago and I’ve Been falling asleep anywhere including work and driving. Just like if I had none. I had
    no side effects ever with provigil it was great, and never effected sleep day or night just made me feel normal and awake, no extra awake like caffeine, just not falling asleep, which motivated me totally. I’m only 24, have a 5 yr old, own my own business, and another job, getting married next year so I need all the motivtion I can get. I probly just need a double dose of the nuvigil. It’s expensive but hey if I can’t afford it, then according to government, I can go on disability. I hope provigil Is good for u!!

  • My doc. began me with 200mg Provigil once a day. It was a wonder drug- I felt normal again, slept well at night and woke up refreshed. By the 3rd day, I noticed cracks at the corners of my mouth and a deep red stripe going down the center of my tongue, and a sore throat. It turns out that I’m allergic to my wonder drug. So I’m back to something less than a normal life. My doc. is considering trying the Nuvigil on me, but if it is the same thing with a new name, may as well save my money.

  • I had the exact opposite problem as Melissa. I was diagnosed this past summer with narcolepsy and my dr started me on 200 mg provigil once a day and upped it to 400 mg (200mg twice a day) when it wasn’t having any effect. Two months of the provigil got me nowhere but 10lbs lighter (nice side effect, but not what i was looking for in such an expensive drug). So I got some free samples of nuvigil from my dr. Did a week of 150mg once a day. Didn’t notice much change if any, so the next week he upped it to 250mg. And it’s actually working. I still don’t eat as much as I used to, but I’m ok with that…small price to pay for being able to stay awake during the day. I still nap a few times a week and have trouble waking up (both from the night and from naps), but I definitely see a big difference. When I forget to take the nuvigil, I spend my entire day planning everything around when I can get a nap in. Not the most productive way to be. Granted, I’ve still got about 6 months left of coupons for it and it’s still fairly expensive, but provigil currently costs more and doesn’t work for me at all. Yeah cephalon is being pretty shady about things, but that doesn’t mean the drug itself is worthless.

  • I was involved in a study of Provigil a few years ago and can’t wait till Wal-M offers it as a generic. $295 for a 30-day supply is just way too much. This drug is simply marvelous. With no side effects at all, it kept me from falling asleep in the afternoons and gave me access to the language center in my brain in a way that I’d not had previously or since. I call it my “smart pill.” I can easily see why people who have it would spend 300 bucks a month for it. Thank God for expiring patents and Walmart generics.

  • I’m a chemical engineering major with narcolepsy and i’ve looked into the chemical differene. They are the same in chemical formula but, sorry to get technical, provigil is one enantiomer and provigil is a racemic mixture of both enantiomers. This means they react differently despite looking like same chemical. So they arent trying to scam you, but i’ve taken both and nuvigil only seems to keep me alert at night. I can still fall asleep when on provigil, but only when i try to. When is walmart supposed to be getting a generic?

  • I just started taking Nuvigil today. hating the side effects but already been through it with Provigil so I know it will get better. I have Narcolepsy and was previously on 600 mg a day and still falling asleep. I have read both good and bad about both medications and ya the price sucks…and i just got laid off and have no insurance…so a generic at a cheaper price sounds awesome BUT after being on such a high dose and still falling asleep all the time, I am willing and hoping the Nuvigil is better. at this point just want to live a normal life and being so darn tired all the time interferes beyond belief! i’ll post again in a couple weeks when the side effects subside and let you know how i am doing. right now i am so very hopeful…just gotta be because it can only get better right? if anyone else with severe narcolepsy has tried both medications please let me know how the worked for you. would like your input =)

  • hi…I have been on provigil since it came out…200 mg in am and 200 pm…I take it with two large starbucks and then take two hour nap. My Dr just switched me to Nuvigil…He said it should be better….But I went on this site to find out comparison of doses…I have been given 250 mg once a day..which I understood was max…note…I had to fight my insurance company for dosage of 600 mg of provigil…diagnosis chronic fatigue, sleep apnea hyperthyroid due to malignant thyroid cancer.
    So…if 250 mg. of Nuvigil is only 500 mg of Provigil…they have taken me down in dosage…why would this help me!!!….No wonder my pharmacy cleared this script no problems!
    Anybody know of any links to dosage that says other than 250?

  • Absolutly,Nuvgil is no differnt then provigil, actually I don’t think it works as good. As for the price of nuvigil verses provigil I take 3 200mg 3 times a day and the cost is 930.00 a month from CVS. Even my insurance company is pushing nuvigil. I guess they were bougt by the C man also. They refused to pay for my provigil and said why not just try Nuvigil…it juat doesn’t work the same. I knew what the c man was up to when I heard about the new drug

  • I have taken the Provigil since it first came out. It really works good with almost no side affect that I ever noticed. Doc put me on Provigil because Insurance company took it off their list (Obviously because the company jacked up the price and brought out Nuvigil). Been taking the highest dose of Nuvigil and I don’t think its as good. Provigil definitly works better and I noticed I get alot of head aches from Nuvigil where I did not with Provigil. My pharmisist said that it has a different way of working but close to the same. I think its a buch of crap that drug companies can get rich with a monopoly on a drug, than jack up the price to pursuade the insurance companies to drop the same drug that has worked great for 12 years and now stuck with head ache city and something that does not keep me awake as good. Trying to find assistance with my pills for six months because I have to go private Insurance and none of them will cover pre-existing conditions which is another legal scheme. When the price drops on Provigil or Generic form comes out Nuvigil is history!

  • Did you all know that Provigil *modafinil* has been off patent for years. The drug company (Celgene) paid off generic companies not to make generic Provigil.

    There should be almost no difference between Provigil and NuVigil. None. It is simply that Provigil contains right and left handed molecules, anad NuVigil contains only left handed molecules.

    It’s like Prilosec and Nexium, or Celexa and Lexapro.

  • Provigil has been a wonder drug for me. After years of falling asleep at the drop of a hat; having to allow myself 2 or 3 times as long to drive somewhere in case I had to pullover and sleep, and convincing my employer to let me telecommute to keep from getting caught sleeping at my desk, I feel like a new person. My family can’t believe the difference in me, and I’m relearning what it’s like to have a life again. The doctor started me out on 200 mg and we saw improvement, but not as much as hoped for. We went to 400 mg per day and that did the trick for me…that is until I changed jobs and had to combat the combined effects of narcolepsy with shift work. The doctor added and addtional 200 mg per day as needed and I take the extra pill only rarely but it has gotten me through some challenging days. I’m perfectly happy staying with Provigil except for the cost, but long-term, it seems that it will eventually be more cost effective to do so if I catch the gist of this thread. It would be great to get a generic version, though!

  • I have an atuo immune and my doc has had me on Provigil for almost three years. Insurance does not cover any of it. I pay almost $600 a month inorder to fight the effects of my illness. I am switching over to NuVigil in hopes that the insurance company will cover some of the cost. Fighting the cronic fatigue takes more than one pill a day. I am taking three a day just to stay awake. I love Provigil just not the cost. The drug company and the FDA needs to look at the facts that this medication should be allowed for cronic illnesses!!!

  • There should be some measurable differences. The right enanitomere (R-modafinil = Armodafinil = Nuvigil) probably has more favorable characteristics either with respect to potency, side-effects, slower elimination from the body, etc. The fact that the dose is lower can be a good sign. Companies commonly extend their patents by isolating one of the enantiomeres and act like it’s a second generation drug.

    It eventually becomes clear whether or not it’s a substantial improvement, so I wouldn’t go switching unless significant improvements are reported over the original and/or the price is similar (i.e. both/neither are generic).

    If there are increased side-effects, they may have chosen the molecule with the wrong chirality to maximize one property like potency over others like health effects that are actually more desirable to customers in the long-run. It’s a business decision, so don’t take it personally. No amount of industry regulation can approach the value of self-education on something as dangerous and potentially miraculous as drugs, legal or not.

  • I started taking Nuvagil with the 14day trial while trying to get my incurance though. My insureance denied it but said provigil was fine. So I took the Nuvagil tell I got the provigil. On the Nuvagil I felt wonderful and awake for the first time in my memory (I just got diagnosed with narcolepsy) I had trouble getting to sleep some times but I did alright. Now that I am on provigil I am having crazy mood swings I nearly yelled at a customer at work today and nearly stormed out another time. I feel extreamly bi polor. From your posts I may wait to see if this goes away but if not I dont know what i will do. Because I cannot take the provigail if this keeps up and the nuvagil costs so much!!! I am going to look for programs that may be able to help me in the mean time. But I really dont want to go back to sleeping 12-18hrs a day.

  • If it is an isomer- then consider this; dextroamphetamine has 2x the potency of “racemic” amphetamine.

    So yes, isomers can have significant differences, in both their effects as well as toxicities.

    By this set of facts; IF nuvigil is the more active isomer, it may be considerably longer lasting.

    That is IF the isomer in question is active at receptors better than provigil, metabolizes at a slower rate.

  • Gerry Higgins, Ph.D. says:

    Patent extension has already been granted by the FDA for Provigil. In addition, Nuvigil is not covered by many health insurance plans, but Provigil is. Finally, the pharmacology discussed here is not definitive. Very little is known about the pharmacodynamics of either drug.

  • My husband’s doctor prescribed Nuvigil 150 mg instead of Provigil due to the cost. However, we have been paying $465/month for Nuvigil. Our insurance will not cover any of it.
    Hoping that generic Provigil comes out soon.

  • Nuvigil is an amazing drug. I had been suffering from major fatigue problems that impacted my life on a catastrophic level. Nuvigil seemed to address the problem directly (ie, not just a stimulant overcompensation but actually focused on the problem [lack of histamine]). It’s no surprise a business would try to keep their competition out of bounds. After all they did invent the thing!! IT’S BUSINESS PEOPLE!!!! I’m in the sam e problem as everyone else. I need some medication for school and can’t afford $400/mo. I don’t understand how keeping people on that price is going to do anything, because anyone who really needs it must go through a non-profit assistance program (maybe that’s how they get the money). Furthermore, I’m so used to switching between drugs, I will have no problem going back to a higher provigil generic dose in 2013 if for some reason the organization will not help me. That is, if I still have insurance. People need to keep in mind that these drugs cost billions to make.

  • Hey guys, I keep reading about people taking tons of this provigil and nuvigil medication with little results. There are other stimulants that address other areas of the body you should look into. If you’re doctor is pushing nuvigil down your throat and it’s not working, it’s because nuvigil address histamine and you probably don’t have a histamine problem. There are a lot of other mechanisms that address fatigue. For example, dompamine and norepinephrine are some that you should research. A major indicator that you are low on histamine is that you will have no ability to shed tears. So if you are just fatigued, but can cry, then you don’t need nuvigil.

    I’m on nuvigil and adderall, address all three items mentioned above. They are all considered “stimulants” by the ignorant. They address pathways that affect alertness on different levels. Just cause you take on doesn’t mean all your problems are solved. From this experience, it is amazing to see the distinction in fatigue problems and hard to explain the changes.. because the broad adjectives explaining the fatigue and alerting effects overlap by the micro distinctions are what counts and difficult to explain. Tip for everyone here, learn vocabulary to explain those micro distinctions and you will do yourself some good.

  • the new is not as good as the old i have been taking the old for day one and made me go to the new about 1 are 2 years ago when it cam out what ever they cut it weath makes it not work as good .
    and my won`t pay for the old . Hop the Generic Provigil comes out soon my won`t pay for eather now i am up to paying out of packit it`s bad

  • Adrenalize13 says:

    Those evil drug companies.  Let’s just get rid of them. Oh, wait if we do that we wouldn’t have any of these meds at any cost, none, nada, zilch. The more money they make, the more research they do to make more meds that help the human condition.  The more money they make the better their share holders do, a majority of which are middle class people who own small amount of stocks or mutual finds that contain shares of drug companies and demand on that oing well to retire.  Most drug companies have paper work you can fill out and if you qualify you can get many meds free or at discounted prices.  Is the set up perfect no because humans aren’t perfect but the more regulation you throw at them or the more headaches you create the fewer new meds will be invented.  If you believe that ingenuity, creativeness , and the inventive spirit is going to happen out of the goodness of people’s heart you are mistaken. There is some of that, but there is a reason the US is a world leader in new ideas (drugs or otherwise).  It is called capitalism.

    • CaruthersSebastian says:

      Much ingenuity, etc., does happen for reasons other than pecuniary rapacity.  Newton and Einstein were inspired by intellectual curiosity, not by a passion to engorge their bank accounts.  The founders of Western civilization, the ancient Greeks, ridiculed the profit-motive as an inspiration for creativity and discovery.

    • CaruthersSebastian says:

       @Adrenalize13 In fact, the strongest motives are other than desire for personal profit.  This is why when governments want to rouse their populations to mass homicide and suicide on the battlefield, they don’t propagandize about the marginal gains to their bank accounts soldiers can hope to realize, if they survive.  Rather, governements rant about “honor,” “duty,” “glory,” etc.  Clearly these are more powerful motives.
      And the vast majority of corporate profits, including those from drug companies, go to the wealthy, not to the middle-class.

    •  @Adrenalize13      So here is another example of someone attempting to defend an unethical practice by calling it  “capitalism”.  CAPITALISM, according to Adam Smith, requires many producers (and many consumers) competing against each other in order to reach a fair and honest price. Cephalon, in this case, has a legal monopoly to control the price and production of their product for seventeen years. Then they seek another round of protection by claiming that they have invested huge resources into the development of a new drug (NuVigil) and must recover their costs before the drug can be classified as generic and open to competition.  Meanwhile, ProVigil is no longer patented and they must deal with the prospect of consumers being able to purchase it at a fraction of the cost of NuVigil- $4,00 vs $450.00 for a thirty day supply. So, they evade the intent of the patent law with the aid of their stable full of highly paid lawyers,by giving the exclusive right of production to a producer of the generic version. One producer, no competition, control over the price. Get It? This is not CAPITALISM any more  than the the sale of drugs on the street by “dealers” is CAPITALISM. What’s missing is an ethical component  that makes real CAPITALISM work. If producers and consumers do not control their greed and keep the market functioning as it was intended, we are all harmed. Producers who are honest, humble and service oriented serve us well. Those who prefer the temporary gains of monopoly are not CAPITALISTS.

  • My husband’s doctor has prescribed Nuvigil 250mg twice a day.  It is costing $882 per month, and our insurance covers none of it.  Highway robbery!  

  • I just switched back to Nuvigil from generic Provigil because my insurance said the generic was cheaper so I had to prove that generic Provigil didn’t work for me before I could go back to Nuvigil. Provigil worked for the most part, not as well as the Nuvigil though, so I wanted to switch back. I don’t know if it was a mistake or what, but the Nuvigil was nearly $700 cheaper a month for 60 – 250mg pills. It was definitely more expensive when I got switched to the generic in July.

  • I just came across your site. I have Narcolepsy with Cataplexy. I have only been on Nuvigil. MAX dosage I have been advised by several specialists is no more than 250mg per day. I found a foundation that financially assists patients with Narcolepsy. They paid a great portion of my monthly Cobra premium until I became eligible for Medicare thru SSDI. Disability due to Neuropsychiatric Lupus. I would be happy to share this information.

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