Concerns mount over trends in allergy and asthma drug use and coverage

With Claritin expected to become available over the counter, some physicians are wondering about the long-term impact of patient self-diagnosis and self-treatment.

By Stephanie Stapleton, AMNews staff. Dec. 9, 2002.

Washington -- Emerging trends related to the availability and insurance coverage of some allergy drugs are causing allergy and asthma doctors to breathe uneasily.

These physicians are expressing concern that changes in the drug marketplace could severely impact patient care and access to high-tier allergy medications, such as Claritin (loratadine) and other nonsedating antihistamines.

Their anxiety, which was the subject of a Nov. 12 press briefing by the American College of Allergy, Asthma and Immunology, stems from a combination of market forces.

First, Schering-Plough Corp., the maker of Claritin, applied to the Food and Drug Administration last spring to switch all indications and market all formulations of the company's Claritin brand of nonsedating antihistamines to over-the-counter status. The company's submission was assigned a standard review by the FDA and, at press time, final action was expected at the end of November.

Some health industry observers predict that health insurance carriers may respond to this switch and other market factors by further limiting coverage or charging higher co-payments for the next-phase drugs, such as Clarinex (desloratadine).

The combined result, say physicians, will be more out-of-pocket costs for patients. Ultimately, this added expense could trigger patient noncompliance with drug regimens, undermine successful treatment plans, and cause safety problems and quality-of-life issues as patients turn to older, cheaper medications that cause drowsiness. [...]