New Sleeping Pill Daridorexant Faces Access Hurdles on NHS Despite Promising Results
London, UK – A new drug offering a potential breakthrough in insomnia treatment, daridorexant, is facing patchy access across the National Health Service (NHS), according to leading sleep experts. While hailed for its low risk of dependency and avoidance of rebound insomnia – issues plaguing older sleeping pills – cost and limited availability of first-line therapy are hindering widespread use.
Daridorexant, approved by the National Institute for Health and Care Excellence (NICE), works by blocking orexin receptors, effectively reducing the brain’s “stay awake” signal rather than forcing sedation. Clinical trials suggest it can cut night-time waking by around 20 minutes and sleep onset by 12 minutes, with patients also reporting improved sleep quality and daytime functioning.
however, access remains a important challenge. Consultant neurologist and sleep expert prof. Guy Leschziner notes a stark cost difference: “Fourteen tablets of zopiclone cost the NHS 82p, compared with around £42 for 30 daridorexant tablets.” This price disparity, coupled with NHS budget constraints, means hospitals bear the cost when specialists prescribe the newer medication.
Experts emphasize that daridorexant is intended as a second-line treatment, to be considered after Cognitive Behavioral therapy for Insomnia (CBT-I). Prof. Leschziner highlights this intended approach: “Doctors are urged to prioritise CBT-I…so tablets are only used if therapy fails,isn’t available or isn’t suitable.”
The problem,however,is the inconsistent availability of CBT-I on the NHS. “Access to CBT-I on the NHS is patchy, so many patients fall through the cracks,” Leschziner added.
Prescribing of daridorexant is currently growing at approximately 12% per month, but uptake has been slower than initially predicted by NICE. Prof. Colin Espie of Oxford Sleep Medicine stresses the continued importance of prioritizing CBT-I,stating,”Patients deserve the most evidence-based care – and in this condition,that means therapy,not tablets.”
Dr. Alanna Hare, President of the British Sleep Society, acknowledges a typical “lag” in the rollout of new drugs, but notes ongoing efforts to increase awareness. She confirms NICE has demonstrated the drug’s cost-effectiveness.
While the majority of patients experience improvements with daridorexant, Prof. Leschziner cautions against unrealistic expectations, stating it is “not a wonder drug” and doesn’t work for all.
Approximately 116,600 adults are projected to begin treatment with daridorexant in 2027-28, accounting for expected population growth. Potential side effects include headache, sleepiness, dizziness, and nausea, with less common effects perhaps impacting mood or worsening depression in vulnerable individuals.
