PHARMAC to fund sleep disorder treatment

PHARMAC will fund a new treatment for the sleep disorder narcolepsy from 1 May 2011.

Narcolepsy is a condition that causes people to be excessively drowsy during the day, or to fall asleep when they don’t expect to. Onset can be sudden and can affect people going about everyday activities such as moving about the house, being at work or while driving (though typically, people with narcolepsy are not permitted to drive).

PHARMAC’s Medical Director Dr Peter Moodie says that narcolepsy is typically treated with stimulant drugs. For people with particularly severe symptoms, this can include treatments such as methylphenidate and dexamphetamine, which are also used to treat ADHD.

Modafanil, however, can only be used as a treatment for narcolepsy.

“Clinical trial results show that for some people, modafanil can be a more effective treatment than other stimulant drugs, so this is a useful addition to funded treatments,” says Dr Moodie.

“Modafanil will be funded as a `second-line’ treatment for narcolepsy, which means that people will have to try the funded stimulants before they can receive funded modafanil. We are taking this step to ensure modafanil’s cost-effectiveness, given that it is substantially more expensive than the other stimulants but without good evidence that it is more effective.”

At present there are 200 people receiving funded methylphenidate or dexamphetamine for narcolepsy, approximately 75% of whom are taking methylphenidate. PHARMAC estimates that up to 85 people will receive funded modafanil after three years. Numbers are expected to grow over time as, once stabilised on treatment, people continue taking these medications long-term.

The five-year cost of funding modafanil is estimated to be approximately $950,000.