OTC Claritin prompts coverage decisions

Employee Benefit News, February, 2003 by Jill Elswick

When Schering-Plough's non-sedating antihistamine (NSA) Claritin went over the counter last December, plan sponsors confronted a big question: What coverage would they now provide for other prescription-only NSAs like Allegra, Zyrtec, and Clarinex?

Sponsors naturally began to weigh economic incentives to steer consumers toward OTC Claritin, which at a ballpark cost of $30 for a month's supply is much cheaper than prescription-based alternatives - and less than half of Claritin's cost as a prescription drug. While it's too soon to puzzle out the choices employers are making, health industry representatives caution that there are pros and cons to every benefit design choice.

Four alternatives

For help, many employers have turned to their PBMs.

"Our goal is to help them realize the best possible cost savings," says Steve Littlejohn, VP of corporate communications for Express Scripts. "But we also recognize that they'll be assessing ...