Motofen is higher priced than both Imodium and Lomotil, does not have a generic equivalent, and is only available by prescription in the United States. Many United States insurance companies do not include Motofen as one of their formulary drugs, causing consumers to pay the highest copay, if it is covered by their health insurance at all. This is most likely due to the high cost of the medication itself, and the fact that similar lower-priced medicines can help ease symptoms of diarrhea. The United States is currently the only country where Motofen tablets are prescribed, approved by the government, and sold. Miscellaneous information
Strangely, Motofen is only included in the Physicians Desk Reference (PDR) for the years 2005 and 2006 as a literal snippet entry. Nothing is said about the indications and usage, only the ingredients, current appearance (at the time of publishing), NDC#, and the quantities in which it is supplied. As of August 1, 2008, Motofen appears to have been discontinued by Valeant Pharmaceuticals. No reason has officially been released, and many severe irritable bowel syndrome (IBS) sufferers, for whom medications such as Imodium or Lomotil did not satisfactorily treat them, were left wondering why it was no longer available. The few pharmacists that were familiar with Motofen and their wholesalers were not given any notice either.
In threads on medical sites, such as, WebMD, that had irritable bowel syndrome as the topic, those sufferers unable to find out any information on Motofens status indicated that many pharmacists were unaware of the medications existence or that it was even unavailable. Many Motofen users reported that they ended up contacting numerous pharmacies in their area to gather what remaining stocks of the little used niche drug. Some state that traveling distances of up to 200 miles, one way, to get the medication; almost exclusively found in smaller, more traditional pharmacies like The Medicine Shoppe or independent local ones, rather than major chains. It is because of the small numbers of those who cannot find relief from the above listed drugs that Motofen can run up to $200, out of pocket, for a monthly supply. As a result, there are virtually no health plans where Motofen is not an off-legend medication. According to e-mails and calls to Valeants customer service department, there was apparent issue with a manufacturer of one of the chemicals used in the making of difenoxin. This chemicals name, nor the manufacturer, would not be released to the public at-large. It was said that the manufacturer was not in the United States.