OTTAWA, ON, Nov. 10, 2026 /CNW/ -- Newer insomnia treatments known as dual orexin receptor antagonists (DORAs) could generate substantial societal cost savings compared to commonly prescribed legacy therapies, while also reducing productivity losses and injury-related events associated with chronic insomnia, according to a new report from Signal49 Research.

Chronic insomnia affects approximately 10 per cent of Canadians and is associated with an estimated economic burden of $1.9 billion annually. While cognitive behavioural therapy for insomnia (CBT-I) is widely recommended as a first-line treatment, access barriers often limit its availability, resulting in continued reliance on pharmacological therapies. According to the report, treatment patterns continue to be shaped by access constraints, reimbursement frameworks, and established prescribing practices rather than clinical appropriateness alone.

The report compares DORAs with two commonly prescribed classes of insomnia medications, benzodiazepines and Z-drugs, using a cost-consequence model that evaluates outcomes relevant to patients, workplaces, and health systems over a 12-month period. The analysis examined productivity-related outcomes, workplace accidents, motor vehicle accidents, falls, hip fractures, healthcare utilization, and medication acquisition costs.

Across the outcomes examined, DORAs were associated with lower productivity losses and healthcare-related costs than benzodiazepines and Z-drugs. Among working-age adults, annual productivity losses were estimated at approximately $12,000 per person for DORAs compared with approximately $20,000 for benzodiazepines and more than $16,000 for Z-drugs. Although DORAs currently have higher medication acquisition costs, the report finds these costs may be partially or fully offset by savings elsewhere in the system. Overall, the model estimated annual cost savings of $16,706 per person compared with benzodiazepines and $13,161 per person compared with Z-drugs when productivity, safety-related outcomes, and healthcare costs were aggregated.

Additional savings were observed across safety-related outcomes. Compared with benzodiazepines and Z-drugs, DORAs were associated with lower costs related to motor vehicle accidents, workplace accidents, falls, and hip fractures. The most significant differences occurred among older adults, where lower hip fracture risk was associated with substantial reductions in hospitalization and wage-loss costs.

The report also draws on interviews with people living with chronic insomnia, healthcare professionals, and public funders. Participants consistently identified fragmented care pathways, limited access to behavioural therapies, and reimbursement frameworks anchored to legacy treatments as important barriers to care. Clinicians reported that medication choices are often shaped by affordability and coverage restrictions, while patients described challenges accessing timely and appropriate treatment options.

According to the report, improving chronic insomnia care will require better alignment between clinical evidence, treatment pathways, and reimbursement frameworks. The research identifies opportunities to strengthen consideration of safety outcomes, productivity impacts, real-world evidence, and long-term management needs when evaluating treatment options for chronic insomnia.

SOURCE Signal49 Research