Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that, despite a benign safety profile, Takeda's Rozerem (ramelteon), the first unscheduled agent approved for treating insomnia, faces enormous hurdles -- from unfavorable formulary positioning to primary care physicians' concerns about its onset of action and ability to maintain sleep.
"Although a high percentage of primary care physicians select Rozerem as a first-line agent for primary, chronic insomnia, more than 60% of primary care physicians rank schedule IV nonbenzodiazepines as the most effective agents," said John Ensign, analyst at Decision Resources. "In addition, though 91% of primary care physicians express 'some' or 'significant' concern about the safety of schedule IV hypnotics, prescribing trends show that Rozerem is capturing little market share from these agents."
According to the new PhysicianForum report entitled Drug Scheduling and Safety: Impact on Prescribing and Coverage, HMOs have positioned novel hypnotics such as Lunesta and Rozerem in high tiers, placing them at a competitive disadvantage. Despite being priced approximately 20% below leading scheduled hypnotic agents, Rozerem is on tier 3 at all HMOs surveyed. HMOs may wish to deter patient-switching from Ambien to Rozerem at this juncture because the former loses U.S. patent protection this month (October 2006). HMOs' tier assignment of Rozerem and Lunesta encourages continued use of the soon-to-be generic Ambien, ensuring that it will remain the leading agent for this indication.
Drug Scheduling and Safety: Impact on Prescribing and Coverage is based on a U.S. survey of 143 primary care physicians and 21 HMO pharmacy directors. Their responses were compared to assess similarities and differences of opinion regarding clinical, economic, and scientific factors.
PhysicianForum is a primary research service from Decision Resources that offers access to high-volume-prescribing physicians, specialists, and managed care organization representatives in the United States; analysis of events and survey participants' responses to them; insight into prescribing patterns; and an examination of the implications of events and issues for the pharmaceutical market.
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SOURCE: Decision Resources
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