Decision Resources, Inc., one of the world's leading research and advisory firms for pharmaceutical and health care issues, finds that even if clinical trials demonstrate that the new class of triple reuptake inhibitors (TRIs) launching in 2009 are more effective than selective serotonin reuptake inhibitors (SSRIs), HMOs won't be impressed. A large portion of HMO pharmacy directors are planning on granting TRIs only a tier 3 placement on their formularies.
According to the new PhysicianForum report entitled Acceptance of Next-Generation Antidepressants, even though TRIs were found in Phase II clinical trials to be tolerable, safe, and equally as effective as the SSRI citalopram, half of surveyed pharmacy directors desire more data before coming to a conclusion, and the rest are divided between tiers 2 (15%) and 3 (35%).
"If new data emerge that prove TRIs to be more effective than the generically available SSRIs, more pharmacy directors say they would grant the agents a tier 2 placement, and 35% still maintain that tier 3 placement would be appropriate," said Natalie Taylor, Ph.D., analyst at Decision Resources. "Wellbutrin XL and Cymbalta are two examples of current therapies that are commonly placed in tier 3. If the data show no comparative advantage to the SSRIs, half of surveyed pharmacy directors declare that TRIs would not be covered on their formularies at all."
Acceptance of Next-Generation Antidepressants is based on a U.S. survey of 20 HMO pharmacy directors, 75 primary care physicians, and 71 specialists. 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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