Managed Care


Flu season: Most HMO formularies cover Tamiflu, Relenza

MANAGED CARE November 2002. © MediMedia USA
The Formulary Files

Flu season: Most HMO formularies cover Tamiflu, Relenza

MANAGED CARE November 2002. ©MediMedia USA

As the influenza season approaches, managed care patient access to Tamiflu (oseltamivir) from Roche Laboratories and Relenza (zanamivir) from GlaxoSmithKline, the two medications indicated for influenza, looks relatively open. To be specific, when combining the following formulary statuses — non-formulary/covered, on formulary/approved/first or second tier, and prior authorization — over 90 percent of managed care patients currently have access to these two medications. This is according to MediMedia's Formulary Compass, which monitors more than 1,200 HMO formularies.

Roche, for one, is planning a promotional campaign that lets the public know that flu can be treated and that prompt initiation of therapy is important.

The Food and Drug Administration will focus on manufacturers' promotional efforts in this area, ensuring that manufacturers do not overstate the efficacy of their brands.

Now it's just a matter of stocking up on tissues and washing your hands often.

Current Formulary Access for Flu Medications (% of HMOs)



Private Health Insurance Exchanges Conference Washington, D.C. October 7–8, 2014
National Healthcare Facility Management Summit Palm Beach, FL October 16–17, 2014
National Healthcare CFO Summit Las Vegas, NV October 19–21, 2014
National Healthcare CXO Summit Las Vegas, NV October 19–21, 2014
Innovative Member Engagement Operations For Health Plans Las Vegas, NV October 20–21, 2014
4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014