To sleep, perchance to dream

When Hamlet said that he was just echoing the fervent wish of millions of people around the globe.

Cephalon recognizes the issue, hence its application for Nuvigil as a pill for counter-acting jet lag. But what about the flip side. Diphenhydramine (nee Benadryl) certainly offers a safe, effective remedy but it does have some side effects.

But at what price does sleep come? In working with Nicholas Hall, I note the following critical facts:

Wide-Spread Prevalence and Rising

Insomnia is reported to affect 24%-65% of the population in the focus geographies. Since 2001, its prevalence has increased by 13% in the US alone. This rising prevalence translates into market growth for companies applying for Rx-to-OTC switches.

Consumer Preference for Self-Medication

Consumers in the focus countries are increasingly willing to self-medicate and have proven themselves to be responsible users in the past. Self-medication will only rise as health awareness among consumers increases, and this will benefit companies going for OTC switches.

Accident-Risk/Productivity Loss

Around 28% of automobile drivers in the US have fallen asleep while driving. Another study estimates 10,000 to 20,000 avoidable casualties due to accidents caused by drowsy driving in France annually. This risk to public health can be avoided by providing the public easier access to OTC insomnia drugs.

Financial Burden on National Systems

The annual cost of insomnia in the US is $42bn in direct and indirect costs. The corresponding cost for France was $1.4bn in 1999, and a similar financial burden is estimated in other countries. Easier access through OTC switching will make its prevention easier, resulting in reduced indirect burden.

Government Policy Could Reduce Its Cost Burden

Governments in developed nations have taken proactive measures to reduce the healthcare burden by switching prescription drugs available on insurance to OTC. The UK government has specifically pledged to double the number of switches in a year to ten.

The easy answer: Balanced well-regulated Rx to OTC switches. It would be great to be able to switch short-acting Ambien. Explore the possibilities of Lunesta or Rozerem.

However, the pharma and consumer healthcare would never derive the true benefits until regulatory agencies really get serious about switch. They worry about the cost burden to the government and understandably the safety aspect. But there are tools, programs and efforts that can be made. And yes, Virginia, there is an even a case for Viagra.

But, before we get active, let’s start with something we all need to function. A new, refreshing way to sleep.