06/29/2007   Generics First - Antidepressant Program

For our commercial, Medicare Part D and self-insured clients who have selected standard prior authorization, on Oct. 2, 2007, Asuris will launch the Generics First – Antidepressant Program, the newest Generics First program from RegenceRx^®.

Recent changes in the antidepressant industry have put more generic medications on the market. The availability of so many generic options makes now a good time to encourage people to try out generics, which are equally effective but much less costly than brand-names.

This program requires that members who fill a new prescription for any of the brand-name selective serotonin reuptake inhibitor (SSRI) antidepressants be asked to try the generic version of the brand-name first ("new" meaning they haven’t taken the medication in the past 120 days). Existing members who are currently taking brand-name medications will not be asked to switch.

• citalopram* (Celexa^®)
• fluoxetine* (Prozac^®)
• fluvoxamine (Luvox^®)
• paroxetine** (Paxil^®)
• sertraline** (Zoloft^®)
• bupropion SR/XL* (Wellbutrin SR^®, Wellbutrin XL^®; 300mg)
• mirtazapine (Remeron^®)

A preferred brand-name (tier two) antidepressant is Effexor XR®. Non-preferred/non-formulary (tier three) options are Cymbalta® and Lexapro^®.

RegenceRx has performed an extensive analysis of the scientific data and relative costs for the available antidepressants. For the majority of patients, generic SSRIs provide effective treatment. (For example: About 70% of patients with depression will likely respond to an SSRI.)

There’s no convincing scientific data to show that the overall safety/efficacy differs among the various brand-name and generic SSRI antidepressants.

Implementation

Prior authorization will apply only to new prescriptions for:

• Cymbalta
• Lexapro
• Effexor XR
• Paxil CR

Exceptions may be made on a case-by-case basis. Existing members currently taking these medications will not need to obtain prior authorization. Prior authorization for Lexapro, Paxil CR, Cymbalta and Effexor XR will be required starting August 7.

We will notify impacted physicians and providers (including pharmacies) by mail, provider newsletter(s) and Web postings.

Generic medications noted above with an "*" are part of the Generic Incentive Program, which allows up to a 30-day supply at no cost to the member. Those generic medications denoted with an "**" were added to the Generic Incentive Program on June, 1, 2007.

If you have questions about Generics First, please talk with your Asuris Sales contact.

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