Nhs Access To Promising Sleeping Pill Daridorexant Is Patchy, Say Doctors

Tens of thousands of prescriptions person been issued for a promising and non-addictive caller sleeping pill, but doctors opportunity NHS uptake is being held backmost by costs and patchy awareness.

Daridorexant, approved past year, has been prescribed 67,000 times since November 2023, astatine an estimated costs of £2.6m to nan NHS. The supplier has been hailed for helping group autumn dormant faster, enactment dormant longer and aftermath up clear-headed – without nan dependency risks of accepted pills.

But entree is uneven. Prescribing is clustered successful parts of London and nan West Midlands, while immoderate patients are turning to backstage care. By contrast, zopiclone – a acold cheaper and perchance addictive replacement – was issued much than 7m times complete nan aforesaid play betwixt November 2023 and June 2025. Nice had forecast nan NHS would walk £10.9m connected daridorexant successful nan financial twelvemonth 2024-25, but costs truthful acold are overmuch lower, astir £1.5m.

Doctors besides be aware against seeing it arsenic a magic slug solution; while galore patients spot improvements, a sizeable number do not. As pinch each narcotics location are side-effects.

Nice said 995,000 adults pinch insomnia were eligible for curen pinch daridorexant based connected expected organization growth. They estimated 116,600 adults would commencement curen pinch nan supplier successful 2027-28 aft adjusting for expected organization growth.

Prof Guy Leschziner, a advisor neurologist and starring slumber expert, called nan supplier “a important measurement forward”. He said: “Unlike accepted sleeping pills, this supplier carries a debased consequence of dependency and does not origin rebound insomnia erstwhile stopped. Concerns person been raised astir older sleeping tablets and semipermanent cognitive decline, but astatine coming we don’t spot that consequence pinch daridorexant.”

But he said nan quality of medicine was cautious by design. He said: “Doctors are urged to prioritise CBT-I (cognitive behavioural therapy for insomnia), truthful tablets are only utilized if therapy fails, isn’t disposable aliases isn’t suitable. The problem is that entree to CBT-I connected nan NHS is patchy, truthful galore patients autumn done nan cracks.”

Cost is different sticking point. “Fourteen tablets of zopiclone costs nan NHS 82p, compared pinch astir £42 for 30 daridorexant tablets,” said Leschziner. “It’s acold easier to entree privately, but wrong nan NHS, hospitals carnivore nan costs erstwhile specialists prescribe it – and that money has to beryllium recovered from elsewhere successful already stretched budgets.”

Daridorexant useful by blocking orexin receptors, which thrust wakefulness, truthful alternatively of forcing sedation for illustration benzodiazepines, it simply removes nan “stay awake” signal.

Side-effects of daridorexant see headache, sleepiness aliases fatigue, dizziness and nausea. Less commonly, it whitethorn impact mood, origin abnormal dreams, aliases worsen slump successful susceptible patients.

Prof Colin Espie, an Oxford slumber medicine expert, said uptake had been slower than Nice predicted, though prescribing is now increasing astatine astir 12% a month.

But he said: “What’s much pressing is nan continued deficiency of entree to nan first-line curen for insomnia, CBT-I. Access to second-line options for illustration daridorexant matters, but patients merit nan astir evidence-based attraction – and successful this condition, that intends therapy, not tablets.”

Dr Alanna Hare, nan president of nan British Sleep Society Conference, said location was “always a lag” erstwhile caller narcotics were rolled out, though activity was nether measurement to raise awareness.

She said cost-effectiveness had already been demonstrated successful Nice’s appraisal, adding: “Daridorexant improves slumber by cutting night-time waking by astir 20 minutes and slumber onset by 12 minutes, but much importantly, it boosts people’s cognition of slumber value and their daytime functioning.”

She stressed that CBT-I remained nan astir effective treatment, benefiting astir 80% of patients. “Even little behavioural interventions tin work, and integer platforms for illustration Sleepio and Sleepstation are captious to delivering CBT-I astatine scale,” she said. “Daridorexant should beryllium seen arsenic complementary to, not a replacement for, therapy.”

Leschziner said that while nan “majority of patients spot improvements pinch daridorexant”, it does not activity for “a sizeable minority”. He said: “Expectations should truthful stay realistic, arsenic it is not a wonderment drug.”