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Sleep-Pill Push Gets Tossing and Turning; Drug Companies Up the Ad Dosage to Get You Snoozing

Posted on: Sunday, 31 July 2005, 18:00 CDT

Call it World War ZZZZZZZ.

Several drug companies, including one Bay State firm, are girding for a long battle as they take to the airwaves to promote a new generation of sleeping aids for an already multibillion-dollar market.

The first volley of ads for insomnia medications came in April when Westboro-based Sepracor Inc.'s Lunesta hit the market. Lunesta is the only drug approved by the Food and Drug Administration for longtime use.

Sanofi-Aventis A, maker of Ambien, fired back with a "fairly aggressive" direct-to-consumer advertising campaign, said Ian anderson, a pharmaceuticals analyst with SG Cowen in Boston.

Sanderson predicts another volley by the end of summer, when Sanofi-Aventis launches a new longer-acting Ambien and Takeda Pharmaceuticals launches its product, Rozerem.

"It's a competitive market," Sanderson said. "It's very much driven by general practitioners who write about 60 to 65 percent of the prescriptions."

"Clinicians tells us only about 50 percent of patients who should be treated for insomnia are currently treated," Sanderson said.

Sanderson said the total number of prescriptions in the sleeping aid market has been relatively flat since Lunesta was launched, but he expects the market to expand.

Some doctors find the marketing of insomnia worrisome.

"We've already started to see an enormous marketing push for these drugs, with insomnia now labeled the latest `epidemic' threatening the health of America," said Dr. Jerry Avorn, a Harvard Medical School professor and author of the book "Powerful Medicines."

Avorn says many insomnia patients could find restful sleep simply by avoiding stimulants such as caffeine and nicotine or by getting enough exercise.

"There's no money to be made advertising those simple lifestyle solutions, but there are billions to be made getting patients onto lifelong use of expensive medications," Avorn said.

But Dr. John Winkelman, medical director of the Sleep Health Center at Brigham and Women 's Hospital in Boston, said a majority of people with insomnia go untreated and don't talk about it with their doctor.

Insomnia and other sleep disorders are oftentimes an opportunity to treat underlying disorders such as depression and anxiety disorders, Winkelman said.

Winkelman said if the ads get people to call their doctors, it's a good thing. "People should be encouraged to talk to their doctors about sleep problems," he said.

"Sleep has been ignored as an important aspect of overall health quality."

"I don't see it as troublesome," Winkelman said. "It's better than ads about beer."

What a bunch of knock-outs

You can't tell the players without a scorecard. Here are the meds that will be duking it for the multibillion-dollar insomnia market.

AMBIEN: The best-selling insomnia drug in the U.S., with almost $2 billion a year in sales. Sanofi-Aventis expects Ambien CR to win FDA approval and reach pharmacies this summer.

LUNESTA: Chemically similar to an insomnia medication long used in Europe. Lunesta has been shown in clinical studies to be effective for up to six months.

INDIPLON: A yet-to-be-brand-named drug being investigated in late- stage trials by Neurocrine Biosciences and Pfizer.

ROZEREM: A drug investigated by Takeda Pharmaceuticals that has yet to receive FDA marketing approval but has won FDA acceptance of its proposed brand name.

SONATA: Fast-acting medication sold in generic form under the name Zaleplon.

TRAZODONE: Sedating anti-depressant that is not approved as an insomnia treatment but has long been prescribed for it.

Source: Boston Herald

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