Managed care plans give nod to new drugs

New hypertension medicines - angiotensin II receptor blockers - are among the more popular products gaining acceptance in the managed care market, according to Newton, PA-based Scott Levin's annual spring formulary survey.

The ARBs, new antihistamines, an antidiabetic drug and an Alzheimer's drug were listed by pharmacy directors as the medicines most commonly added to managed care plan formularies.

ARBs, such as Merck's Cozaar and Novartis's Diovan, gained support from pharmacy directors because they boast better side-effect profiles than older hypertension products known as ACE inhibitors. As a result, patients who typically discontinue use of hypertension medicines after one year due to cough, headache and edema, are more likely to comply and persist with the newer products.

Nearly half of the 120 surveyed managed care pharmacy directors indicated that at least one ARB was on their formulary. Of those respondents, 88% chose Cozaar for their formulary and 24% chose Diovan.

Even when ARBs were not on formularies, they commanded respect. Fifty-nine respondents said they would cover an ARB if it was not on their formulary list. Of those, 69% said they would cover Cozaar and 78% said they would cover Diovan.

Gaining ground

Other products that gained notable ground on formulary lists included Hoescht Marion Roussel's Allegra, Parke-Davis's Rezulin and Eisai's and Pfizer's Aricept.

The antihistamine Allegra did not bypass Schering-Plough's Claritin, which maintained the highest formulary status in that class at 95%. But it did assume some of the market share abandoned by Hoescht Marion Roussel's nonsedating antihistamine Seldane. Allegra improved its rating from 21% to 76% since its launch in late 1996.

Despite a relatively recent launch in early 1997, the antidiabetic product Rezulin captured formulary status with 20% of managed care plans. That hardly compares with the market presence of Bristol-Myers Squibb's Glucophage, which is included on 91% of plan formularies, but 55% of pharmacy directors indicted they would cover Rezulin even though it wasn't on their formularies.

Value-added services from Pfizer and Eisai, meanwhile, boosted Aricept closer to its primary competitor, Warner Lambert's Cognex. The product, which is used to treat mild to moderate Alzheimer's disease, captured formulary status on 29% of plans. Cognex - no longer promoted to physicians or managed care - is covered on 45% of plans. PR