Generic versions of Prozac (fluoxetine) have been available to patients for approximately 18 months, and a court decision is expected this month on whether generic Paxil (paroxetine hydrochloride) may be marketed. Yet in the face of this, several SSRI brands have increased HMO drug formulary access.
We analyzed 2001 and 2003 data from MediMedia's Formulary Compass database for the HMO market. GlaxoSmithKline's Paxil's "approved" status (approved, tier 1, tier 2, tier 3) increased from 91 percent to 98 percent of patients since generic versions of Prozac became available. At the same time, the requirement for prior authorization of Paxil fell from 6 percent of patients to 1.5 percent of patients in 2003. A similar situation can be found with Pfizer's Zoloft. Zoloft increased its approved status from 87 percent to 90 percent of patients. Celexa now has approved status for 78 percent of patients, with the newest entrant into this market, Lexapro, at 57 percent.
MediMedia's Formulary Compass is a constantly updated compilation of formulary information containing product position for over 3,000 separate drug benefit designs for HMOs, PPOs, PBMs, POS plans, Medicaid, employer groups, and private insurers.