Select SSRIs increase level of HMO drug formulary access despite generic incursion












Generic versions of Prozac (fluoxetine) have been available to patients for approximately 18 months, and a court decision is expected this month on whether generic Paxil (paroxetine hydrochloride) may be marketed. Yet in the face of this, several SSRI brands have increased HMO drug formulary access.

We analyzed 2001 and 2003 data from MediMedia's Formulary Compass database for the HMO market. GlaxoSmithKline's Paxil's "approved" status (approved, tier 1, tier 2, tier 3) increased from 91 percent to 98 percent of patients since generic versions of Prozac became available. At the same time, the requirement for prior authorization of Paxil fell from 6 percent of patients to 1.5 percent of patients in 2003. A similar situation can be found with Pfizer's Zoloft. Zoloft increased its approved status from 87 percent to 90 percent of patients. Celexa now has approved status for 78 percent of patients, with the newest entrant into this market, Lexapro, at 57 percent.

MediMedia's Formulary Compass is a constantly updated compilation of formulary information containing product position for over 3,000 separate drug benefit designs for HMOs, PPOs, PBMs, POS plans, Medicaid, employer groups, and private insurers.

SOURCE: MEDIMEDIA INFORMATION TECHNOLOGIES

Career Opportunities

HAP, a subsidiary of Henry Ford Health System, is a nonprofit health plan providing coverage to individuals, companies and organizations. This executive develops strategies to meet membership and revenue targets through products, pricing, market segmentation and advertising.  Aligns business among Business Development, Commercial Sales, Medicare and Public Sector Programs and Product Development. Seeks to enhance and be responsible for business development and expansion through the development of an effective product portfolio, strong interpersonal relationships and service excellence.

Apply via email to jfedder1@hfhs.org or online at http://p.rfer.us/HENRYFORDlXqAJA

Subscribe to Our Newsletters

Monthly table of contents

Be notified as each issue of Managed Care is available online.

Biweekly newsletter

Recent topics have included:

PTCommunity news

New drug approvals, clinical trials, drug management. Three times per week.

UP NEXT

Managed Care
By Peter Wehrwein
Managed Care
By Howard Wolinsky