Insurer Consider Dropping Coverage of Claritin Rivals if Drug Becomes Available OTC
If Scherling-Plough's blockbuster allergy drug Claritin becomes available over-the-counter, health insurers such as UnitedHealth, Humana and WellPoint Health Newtorks might cut coverage for rival drugs in the same class, including Zyrtec, Allegra and Clarinex, Reuters/Chicago Tribune reports. William Fleming, chief pharmacy officer at Humana, said that the rival drugs work in "similar fashion" to Claritin and can be substituted for each other. "These are clearly interchangeable products," Fleming said, adding, "I've gone out and talked to a lot of our competitors and most folks are looking to" categorize Zyrtec, Allegra and Clarinex in the most expensive drug category (Reuters/Chicago Tribune, 9/12). Already, Sierra Health Services plans to raise copayments for the rival drugs to $50 to "discourage consumers from using them." Other insurers have indicated that they might begin campaigns to encourage consumers to choose generic allergy drugs, which can cost up to 40% less than their brand-name counterparts. According to Tim Anderson, a Prudential Securities analyst, insurers "will eye each others' moves." Anderson said, "Apparently due to competitive reasons, almost all plans told us that they would wait to see what the 'industry standard' is on formulary repositioning" concerning Claritin. The FDA will rule in November on whether Claritin is safe to sell over the counter; two advisory panels have already agreed that the drug is safer than existing products available in pharmacies (Reuters, 9/10).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.