2009 Drug Trend Insights - Prime Therapeutics

Strategic approach to Pharmacy trends+ SeizureRecently launched genericalternatives for Lamictal ® ,Depakote XR, Topamax ® andKeppra ® have improved genericuse and lowered costs; savings willcontinue in 2009 as additionalgenerics are launched.+ ADHDDespite multiple reports of safetyconcerns in the media, utilizationcontinued to increase. Inflationand costs remained high becausecitizen petitions filed with theFDA have continued to delay thelaunch of key generics. 32+ PsychosisDespite the launch of genericRisperdal ® in 2008, multiplebrand products continued todrive large unit price increasesfor antipsychotics.+ AllergyCosts and utilization felldramatically after Zyrtec ® wentOTC in early 2008. Many plansceased coverage for cetirizine;some eliminated coverage forallergy medications entirely.+ Blood thinnersUtilization edged up despitesafety concerns because theconditions treated by warfarin,the leading drug in this class,are becoming more common.Trend was also driven upwardby decreasing generic use andbrand price inflation. Advancesin understanding the enzymesthat cause blood clots to form aredriving new drug development;candidates could reach themarket in 2009, driving up bothutilization and costs.+ InsomniaA continued shift away fromAmbien ® to the genericalternative introduced in mid-2007 helped drive generic use;utilization growth is also slowerthan in recent years. Several newformulations of existing productsare in the pipeline. Coupled withslower but continued utilizationgrowth, insomnia spend is likelyto trend upward in the future.+ LifestyleImproved adoption of availablegenerics (e.g. generic Lamisil ® inmid-2007) drove a strong negativedrug mix and offset inflation.Safety concerns around Chantix ®drove utilization of smokingcessation aids, also classified aslifestyle drugs, down significantly.The result was a strong negativetrend for lifestyle drugs.© Prime Therapeutics 2009 Drug Trend Insights29