What insurance plans cover eszopiclone (Lunesta) for insomnia treatment?

Insurance Coverage and Brand Name for Eszopiclone

Eszopiclone is marketed under the brand name Lunesta in the United States and is covered by most insurance plans, though coverage details vary by specific plan and formulary tier placement. 1, 2

Brand Name Information

• Eszopiclone is sold under the brand name Lunesta in the US market 1, 3
• It was developed by Sepracor (now Sunovion Pharmaceuticals) 1
• Lunesta received FDA approval in December 2004 for the treatment of insomnia 1

Insurance Coverage Details

• Most insurance plans cover Lunesta (eszopiclone), but coverage specifics depend on:
  • The individual insurance plan's formulary
  • Tier placement (which affects copay amounts)
  • Whether prior authorization is required
  • Step therapy requirements (trying other medications first)

Dosage Information

• Available in 1mg, 2mg, and 3mg tablet strengths 4
• Recommended dosages:
  • Adults (18-64 years): 2mg or 3mg 5, 1
  • Elderly patients (≥65 years): 1mg for sleep onset issues, 2mg for sleep maintenance 5, 1
  • The American College of Physicians recommends low-dose eszopiclone (1mg) for elderly patients with insomnia and fall risk 5

Clinical Considerations

• Eszopiclone is indicated for both sleep onset and sleep maintenance insomnia 5, 2
• Unlike most other hypnotics, eszopiclone is not limited to short-term use 2, 3
• It has demonstrated efficacy in both primary insomnia and co-morbid insomnia (insomnia occurring with other conditions) 2
• Eszopiclone has a better safety profile than benzodiazepines or trazodone, particularly in elderly patients with fall risk 5

Common Side Effects

• Most common adverse effect is unpleasant taste 6, 4
• Other common side effects include headache and dry mouth 4
• Generally well tolerated with no evidence of tolerance during 12 months of treatment 2, 3

Cost Considerations

• A cost-utility analysis suggested that eszopiclone is cost-effective for treating primary insomnia in the US 2, 3
• The cost was reported as $3.70 per tablet for all dosage strengths in 2006 4, though current pricing may differ

Insurance Navigation Tips

• Check your specific insurance plan's formulary to confirm coverage status
• Determine if prior authorization is required from your physician
• Ask about generic alternatives if cost is a concern
• Consider patient assistance programs if coverage is limited