A “obstacle course” for the treatment of insomnia

“We really have a two -speed medicine here,” worries Dr. Similarly, Annick Vincent. In addition, For the one who has been a psychiatrist for 30 years. However, it is clear that sleep is a priority for both physical and mental health.

This is why it is concerned that access to two promising drugs against insomnia is a “real obstacle course”.

This treatment is in fact a new family of molecules which acts on the activation. Nevertheless, deactivation of the state of awakening, rather than “to knock” the patient. Moreover, Marketed under the names of Dayvigo and Quviviq, these two drugs are however not covered by the RAMQ. Consequently,

To obtain a refund. Furthermore, doctors must make an exceptional request and prove that the patient does not respond to other treatments against insomnia, “obstacle course” treatment insomnia including the family of benzodiazepines.

“There is a two -page form to be completed. Nevertheless, there is an expectation of three to four months for requests for requests,” explains Dre Vincent. Those who are ready to pay from their pocket pay between $ 75 and $ 100 each month. “It’s quite difficult to access.”

The best treatment – "obstacle course" treatment insomnia

However, “everyone agrees” on the benefits of Dayvigo and Quviviq, says Annick Vincent. “The Inesss [Institut national d’excellence en santé et en services sociaux] recognized the therapeutic value, ”she recalls.

The other drugs indicated against insomnia have several undesirable effects in comparison, insists Dre Vincent.

The benzodiazepine family is commonly used to induce sleep. but it is known for several undesirable effects, especially in the elderly. They should be used in the short term.

“Benzos” can lead to “tolerance. “obstacle course” treatment insomnia dependence, rebound insomnia, residual drowsiness the next day, parasomnies, alterations in cognitive functions and attention that increases the risks of road accidents, falls and fractures”, according to Inesss.

On the other hand, the new molecules, Dayvigo and Quviviq, have less undesirable effects. “There is no tolerance, no dependence, and much less sedation at night,” explains the psychiatrist.

“This is the first choice on a scientific level, clinically and in terms of expert consensus,” said Dre Annick Vincent.

Too expensive for too little

If the RAMQ does not cover the Dayvigo. the Quviviq, it is because “the modest magnitude” of the benefits does not justify the higher cost of the molecule, explains the expert committee of the Inesss.

The other options already reimbursed against insomnia cost approximately four times cheaper to RAMQ than dayvigo, for example.

“Compared “obstacle course” treatment insomnia to benzodiazepines. a drop in the price of minimum 94 % should be granted in order to avoid additional costs in the perspective of the Ministry of Health and Social Services,” explains the INESS in its decision not to reimburse the drug.

According to INESS estimates, the first three years of reimbursement of Dayvigo would cost the RAMQ between 35 and 70 million dollars.

Given the “modest profits of profits” compared to the high cost. the committee which must decide on the drugs covered by the RAMQ said no to Dayvigo and the Quviviq.

“We compare apples with oranges”

Dr. Vincent is well aware of the pecuniary aspect in such a decision, but “we compare apples with oranges,” she says.

“Because there is no treatment reimbursed by the RAMQ for insomnia disorder. Benzos should not exceed a “obstacle course” treatment insomnia month, ”recalls the psychiatrist.

Not to mention that sleep is a crucial aspect of health, insists the expert.

“We are at a stage currently in Quebec where we try to cut everywhere. But there, I think we don’t cut the right places. “

— Dre Annick Vincent. psychiatrist

On the sidelines of Dayvigo and Quviviq which are not reimbursed, the government has set up guidelines in order to depress benzodiazepines.

A “paradoxical” situation which penalizes the many people on the public insurance scheme, according to Annick Vincent.

“For people who have the RAMQ. I must go through the medication that I will have to depress before having the right to have the reimbursement of the other.”

If you have any questions about your medication or your health, consult your doctor or “obstacle course” treatment insomnia pharmacist.