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Sleep Medication: Savings Opportunity With Generic Insomnia Treatment

2007-04-30 12:46

Generic Insomnia Treatment

As more Americans turn to medications for a good night's sleep, the introduction of a generic version of Ambien (zolpidem tartrate) presents multi-million dollar savings for consumers and health plan sponsors, helping to offset spending growth in what has become one of the fastest growing categories of prescription drugs.

According to research released by Medco Health Solutions, Inc., use of prescription sleep medications has grown significantly between 2001 and 2006; yet the availability of generic zolpidem -- an equivalent version of the blockbuster prescription drug Ambien -- could produce savings in excess of $150 million per year for Medco's plan sponsors and their members, helping to ease the financial burden of treating sleep disorders for consumers and health plan sponsors.

"The brand-name monopoly on this drug category that was in part created by hundreds of millions of dollars spent each year in direct-to-consumer marketing and advertising -- is now over," said Laizer Kornwasser, senior vice president, channel and generic strategy, Medco. "With a lower cost option available, and growing comfort level across the board with using generic medications to save money, consumers and plan sponsors are clearly set up to save tremendously."

As of April 27, the FDA has approved 15 different manufacturers to make zolpidem -- a medication used for treating short-term bouts of insomnia -- in 5 mg and 10 mg doses. The generic version of the Sanofi-Aventis drug was launched immediately. Ambien has been used by millions of patients since it was first approved in 1992, and generated $2.2 billion in U.S. sales last year alone -- more than half of all sales for the $4 billion sedative/hypnotic drugs category. Ambien maintained its strong market position despite several competing new sleeping medications.

"Plan sponsors are showing increased interest in many of Medco's cost- management strategies, such as lower co-payments for the generic, step therapy and member generic education programs including cost-comparison tools," said Kornwasser. "In a recent study of members who used Medco's MyRxChoices(TM), an online prescription drug cost-comparison tool, 51 percent made the switch from the brand-name medication to the lower cost generic when shown the savings opportunity -- just one of a number of studies validating the sea change in the acceptance of generic medications."

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Prescription sleep medications have become one of the fastest growing categories of prescription drug spending in recent years, driven largely by more people taking the medications, and the introduction of multiple brand- name prescription sleep medications.

According to a new analysis by Medco, use of prescription sleep medications by children under age 19 surged 45 percent between 2001 and 2006; and 52 percent among adults age 20 and older. Growth in use of the medications among seniors age 65 and older increased 26 percent over the five- year analysis period. While this age category had the lowest percentage increase in use over time, they are the group with the highest use rate overall -- 7 percent, with a slightly higher usage rate among those age 75 and older. The research also found that women are 60 percent more likely to be taking a prescription sleep medication than men.

Yet, with those increases have come increased scrutiny on some safety concerns of the medications in this class. In March 2007, the FDA requested that all manufacturers of sedative-hypnotic drug products, a class of drugs used to induce and/or maintain sleep, augment their product labeling to include stronger language concerning potential risks. These risks include severe allergic reactions and complex sleep-related behaviors, which may include sleep-driving, the FDA report stated. Sleep-driving is defined as driving while not fully awake after ingestion of a sedative-hypnotic product, with no memory of the event.

"While the cost of these new generics will make it less expensive to take these medications, there are some serious risks associated with these drugs that patients and physicians should consider," said Dr. Rob Epstein, Medco's chief medical officer. "Non-pharmaceutical treatments and behavior modification can be extremely effective for sleep problems and should be considered as first-line therapy when appropriate."

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