Cigna Eases Restrictions on Alternatives to Vytorin
Posted by Sarah Rubenstein
April 2, 2008, 10:58 am
Since the controversy over the effectiveness of Vytorin erupted, health insurers haven’t rushed to downgrade their coverage of the cholesterol drug. But Cigna now says it’s suspending its requirements for certain patients to try Vytorin, jointly sold by Merck and Schering-Plough, before trying alternatives, such as Pfizer’s Lipitor and AstraZeneca’s Crestor.
Vytorin remains on the second tier of Cigna’s preferred drug list. Patients who use second-tier drugs pay lower copayments than they do for those on the third tier, which for Cigna includes Crestor and Lipitor.
But Cigna’s “step therapy” approach has required patients who need to reduce their cholesterol by 50% to try Vytorin before moving to third-tier drugs, barring a compelling medical reason to do otherwise.
Cigna spokeswoman Lindsay Shearer tells the Health Blog that “based on the questions raised about Vytorin in the Enhance study,” the insurer has put the Vytorin-first rule on hold until its pharmacy policy committee can “evaluate the updated clinical literature and make a recommendation.” Meantime, “we don’t want people arbitrarily stopping taking their medications,” Shearer adds. “This is not a safety issue. It’s an effectiveness issue.”
Dow Jones Newswires, which reported on Cigna’s decision yesterday, adds that a number of drug-benefit plans are revisiting their coverage policies for Vytorin.
Separately, the New York Times weighed in with an editorial today that argues Vytorin and Zetia have been overpromoted. “It is distressingly late to be learning that these drugs may provide little or no benefit,” the piece says.
nytimes.com
Vytorin and sister drug Zetia “are clearly down, but not necessarily out,” the editorial adds. But until other trials clarify the drugs’ effectiveness, “heart experts are surely right that Vytorin and Zetia should be a last resort for patients who can’t get their cholesterol down any other way.”
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