New drugs are expensive
Belsomra (suvorexant) is the newest sleeping pill to hit the market. If you think you might want to try it, or your physician suggests it, keep two things in mind.
As with any new and highly-marketed drug, it’s expensive, although not quite as costly as I thought it might be. According to GoodRx, a 30-day supply of 10mg tablets in my area code will cost on average $275.
Generic Ambien—zolpidem—costs about $30.
Belsomra works differently in the brain than Ambien or Lunesta. Will it work better? Hard to know, since at this time there have been no studies directly comparing the efficacy of Belsomra with the other two popular sleeping prescriptions.
There is a good chance the cost will not be covered by your insurance. At this time, Belsomra is not included in the two largest PBM (pharmacy benefits manager) drug lists or formularies.
The PBM is the middle man between the pharmaceutical companies and the insurance companies. As the insurance companies double down on cutting costs, they are dropping more expensive, name brand drugs from their lists. Check with your insurance company!
New drugs have limited safety records
The second and most important consideration is safety.
New drugs can have a poor history of safety that leads to frequent recalls. Why? Because the initial studies are based on small numbers of subjects. As more people take the new drug, more side effects and adverse reactions are recognized. That’s why I advocate the “Seven-Year Rule”; don’t take a drug that hasn’t been on the market for at least 7 years, unless there is no other option.
A reader contacted me recently about his experience with Belsomra. He has suffered from sleep problems for many years, but neither Ambien nor Lunesta worked for him. He was hopeful that Belsomra, because it works differently, would provide some relief.
He paid $170 out of pocket for a month’s supply because his insurance did not cover it.
This is what he told me:
I know each person’s reaction to a drug is different, but here is my experience. In one word- hell. It did exactly the opposite of its intended purpose. I was up the entire night, and not in the way my insomnia usually manifests. 10 mg tablet, thirty minutes before my regular bedtime , as directed. Eyes wide open all night. Mentally agitated. Today, poor motor skills, heightened aggression (I am not typically remotely aggressive by nature), confusion, disrupted verbal skills.
He reported his bad reaction to the FDA, and they followed up with him.
If you have a bad reaction to any drug, prescription or over-the-counter, you can and should report it to the FDA. Go to my Resources page for a link to to the FDA’s MedWatch program.
Be informed, weigh the risks and benefits of Belsomra
Insomnia and other sleep disturbances can be debilitating, I know, and so difficult to treat. Belsomra, like Ambien and Lunesta before it, will be aggressively marketed as the answer to your prayers. Advertising always oversells the benefits and understates the risks of any product.
Here are some links to give you more information about Belsomra:
- Informulary: Belsomra (suvorexant) Drug Fact Box
- Consumer Reports: Here’s why you can skip the new insomnia drug, Belsomra
Will Belsomra help someone? I hope so. But manage your expectations and use it with caution.
Learn more about why a good night’s sleep is so hard to get: