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Claritin change may affect coverage for other drugs

Tuesday, December 10, 2002

By Virginia Linn, Post-Gazette Staff Writer

As the allergy drug Claritin joins cough medicines and cold tablets on drugstore shelves later this month, some local consumers may see changes affecting coverage of other prescription allergy medications.

As expected, the Food and Drug Administration just before Thanksgiving gave the OK for Claritin -- the biggest selling non-sedating antihistamine drug -- to be sold over the counter. The change will save the government, employers and health insurers $1 billion a year because insurance doesn't cover nonprescription drugs.

On the shelves, a month's supply of Claritin is expected to cost between $17 to $20, slightly more than the $10 to $15 co-pay. This will be a boon to the uninsured, however, who have been paying between $60 and $90 for a month's prescription.

As soon as Claritin is widely available over the counter, Highmark Blue Cross Blue Shield will drop coverage of the drug that has dominated sales of non-sedating antihistamines, which also include Clarinex, Allegra and Zyrtec. Highmark will keep co-pays the same, despite announcements by insurance companies in other parts of the country that they will raise copayments on these similar drugs because consumers now have an over-the-counter choice.

But the region's dominant insurer soon will offer employers the option of dropping coverage of all non-sedating antihistamines, said Phil Neubauer, Highmark spokesman.

Neubauer did not know how many employers would take advantage of this option, but said Highmark already had received several inquiries from work places.

Officials at UPMC Health Plan have not decided on any changes.

HealthAmerica and HealthAssurance won't make any immediate changes on other drug co-pays, according to a company statement, but employers may get the option to end coverage of non-sedating antihistamines.

Aetna US Healthcare has announced that it will no longer cover Allegra, Zrytec and Clarinex unless doctors make a special request. If approved, patients would be charged the highest co-payment.

Not all patients are helped by Claritin, so these changes could hurt patients who can't afford to pay full price or higher co-pays for the alternatives.

Analysts have predicted that prescription sales of Clarinex, Aventis' Allegra and Pfizer's Zrytec will drop as patients self-medicate, insurers drop coverage and doctors suggest trying the over-counter medication before writing prescriptions.

Virginia Linn can be reached at vlinn@post-gazette.com or 412-263-1662. The Associated Press contributed to this report.

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