HMO drug formulary access increases for COX-2s

Access to Celebrex and Vioxx under HMO drug formularies has increased about 50 percent over the past two years, according to data from MediMedia Information Technologies’ Formulary Compass.

Access (defined here as having a status of first tier, second tier, prior authorization or on formulary, but not third tier) to Celebrex increased from approximately 45 percent of members in May 2000 to 67 percent of members in September 2002. For Vioxx, HMO-member access in May 2000 was slightly over 48 percent, compared to September 2002, when access was approximately 70 percent. Bextra, a COX-2 launched in May, lags significantly behind its competitors at 36 percent.

Note that in 2000, there was a status of “not listed but reimbursed,” which no longer exists for this class, and that while the patient may have had reimbursement, it was not through listing on a formulary.

The increased favorable listings of Vioxx and Celebrex can be attributed to the development of agreements between the manufacturers and managed care and pharmacy benefit organizations, as well as direct-to-consumer advertising, the dissemination of prescribing information to physicians, and reports of therapeutic success in treated patients. The Formulary Compass database, updated daily, tracks more than 1,500 HMO drug formularies and brand positions within them.

COX-2 formulary status at HMOs


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