How to Help Your Patients Find Sunosi in Stock: A Provider's Guide

For prescribers managing patients with narcolepsy or OSA-related excessive daytime sleepiness (EDS), Sunosi (solriamfetol) is a well-evidenced wakefulness agent — but helping patients actually get it in their hands requires navigating a specific set of challenges. This guide walks through the strategies, tools, and patient support programs that make the biggest difference.

Why Sunosi Is Hard for Patients to Fill

Three factors combine to create access challenges for Sunosi patients:

No generic: Sunosi is brand-only, with no generic expected until approximately 2042. This means single-source supply and higher pharmacy reluctance to stock heavily.

Schedule IV controlled substance: DEA regulations limit how pharmacies order and store controlled substances. Smaller pharmacies may carry minimal inventory of Sunosi.

Prior authorization required: Most commercial payers and Medicare Advantage require PA before dispensing Sunosi. Step therapy requiring a trial of modafinil/armodafinil is common for OSA indications.

Step 1: Confirm Prior Authorization Before Sending the Prescription

The most common reason patients struggle to fill Sunosi is that their insurance hasn't approved it yet. Before sending the prescription to a pharmacy, verify that PA is in place. Common documentation your team will need to submit:

Diagnosis of narcolepsy (ICD-10: G47.41) or OSA (ICD-10: G47.33) with supporting documentation

For OSA: evidence of CPAP therapy for at least 1 month prior to Sunosi initiation

For OSA: documentation of inadequate response to generic modafinil (and armodafinil for some payers)

Prescriber type: some payers require prescribing by or in consultation with a sleep specialist, neurologist, or psychiatrist

Step 2: Direct Patients to Specialty or Mail-Order Pharmacies

Retail pharmacies near smaller communities may stock little or no Sunosi. Direct patients to:

Mail-order pharmacies (CVS Caremark, Express Scripts, OptumRx): These PBMs maintain robust inventory of specialty brands like Sunosi and can dispense 90-day supplies.

Large chain retail pharmacies: CVS, Walgreens, and Walmart locations with high volume tend to stock Sunosi more reliably than independent pharmacies.

medfinder: medfinder is a service that calls pharmacies on the patient's behalf to check which ones have Sunosi in stock, then texts the patient results. This is particularly helpful for patients who have difficulty making calls themselves.

Step 3: Utilize the Axsome On My Side Program

Axsome Therapeutics' SUNOSI On My Side Program provides dedicated support specialists who can:

Assist with prior authorization submissions and appeals

Identify sources of financial support for uninsured or underinsured patients

Coordinate patient enrollment in the savings card program

For commercial insurance patients: the Sunosi savings card allows eligible patients to pay as little as $9 for up to a 90-day supply. This card is not valid for Medicare or Medicaid beneficiaries.

Step 4: Offer the One-Time Free Trial Voucher

Patients who are new to Sunosi can receive a free 30-day trial through the pharmacy — no enrollment required. This is a once-per-lifetime offer that requires a valid prescription. For patients mid-approval process or waiting for PA, this trial can allow therapy to begin without delay. Prescribers can also request sample packs directly via the Axsome HCP portal at sunosihcp.com.

Step 5: Write 90-Day Prescriptions When Clinically Appropriate

Schedule IV controlled substances may be dispensed in 90-day quantities when permitted by state law and the prescriber writes the prescription accordingly. A 90-day supply reduces how often patients need to refill, decreasing the frequency of stocking problems. Make sure to confirm that the PA approval covers a 90-day supply.

Key Monitoring Points for Sunosi Patients

Monitor blood pressure and heart rate before initiation and periodically during treatment — Sunosi causes dose-dependent increases in both

Control hypertension before starting Sunosi; reassess cardiovascular risk periodically

Assess for psychiatric history; use caution in patients with psychosis or bipolar disorder

Renal impairment: dose adjustment required — Sunosi is predominantly renally eliminated

Recommend medfinder to Your Patients

When you write a Sunosi prescription, let your patient know about medfinder as a resource for locating pharmacies with the medication in stock. It saves patients significant time and frustration, and may reduce the number of calls your office receives about prescription access issues. You can also share our Sunosi shortage patient guide for patient-friendly information on current availability.