Chronic-use drugs top US MCO curbs list

US managed care organization pharmacy executives have named HMG-CoAreductase inhibitors used in the treatment of high cholesterol as the therapeutic class which is most likely to be affected by three-tier co-pays, according to a new survey from Scott-Levin.

Under the three-tier system, which is used by about 80% of MCOs, users tend to pay the smallest co-pay for generics, a higher co-pay for preferred or formulary brand drugs and the highest for brand-name drugs not on the formulary.

79% of health maintenance organization executives and 75% of pharmacy benefit manager executives ques-ioned felt HMG-CoA reductase inhibitors were the class most likely to be affected by three-tier co-pays, followed by proton pump inhibitors to treat gastrointestinal disorders, cited by 77% of HMOs and 92% of PBMs, and then nonsedating antihistamines for allergy treatment, cited by 56% and 58% respectively. They named these classes because of high utilization and the availability of therapeutic equivalents, and some also mentioned their use in treating chronic conditions.