Zyrtec update

Here's an interesting twist on my Sunday column. As you'll recall, I mentioned that my current group insurance has in recent years refused to cover Zyrtec, which I found to be effective in treating my allergies. So I got this message from Zyrtec's PR firm:

Hi Brad,

My name is Eric Tatro, and I’m with Cohn & Wolfe public relations. Today I read your editorial about health insurance that was posted on your blog, and noticed that you had some trouble getting your insurance company to pay for prescription Zyrtec.

We are working with McNeil Consumer Healthcare, who recently announced that the FDA approved Zyrtec and Zyrtec-D 12 Hour (which combines Zyrtec with a decongestant) for use without a prescription. I thought you and your readers might find this interesting, since allergy sufferers will soon be able to purchase Zyrtec anywhere over-the-counter prescriptions are sold without first having to visit an allergist or health care professional. Also, for many allergy sufferers, Zyrtec will cost up to one-third less than prescription Zyrtec. Both medications will be available nationwide in January 2008.

If you would like more information, you can find a full press kit located at http://www.ZyrtecPressKit.com. The FDA also issued a press release on the approval, which can be found at http://www.fda.gov/bbs/topics/NEWS/2007/NEW01750.html. Of course, please let me know if you have any questions or if I can help in any other way.

Sincere thanks,

-Eric

I immediately wrote back to Eric as follows:

    Thanks. Actually, I heard that last week, but it didn't affect my column, since it didn't affect the fact that up to now, my insurance has refused to pay for Zyrtec, and HAS paid for allergy shots, which was the point I was making.

    Here's an irony for you, though: I had already learned that my NEW insurance (that for which I'll be paying $274.42 every two weeks) WILL pay for a Zyrtec prescription. Now that it's going over-the-counter, they might NOT cover the prescription -- I'll have to check, but that's my strong suspicion.

    So if Zyrtec is available to me only over the counter, and the price is only 30 percent less than the amount that was so high my current insurance refused to pay (which had to be really high, when you consider that they DID cover something that had a co-pay -- which would be no more than 50 percent of the total -- of $81.95), then I still won't be able to afford it. With my high premiums, I will be very much boxed into whatever my insurance will cover.

    The only thing that might help me would be if a generic version came available. But from what you're telling me, this is one of those situations where the drug goes OTC, but doesn't go generic -- at least, not yet. Am I right about that? I hope not, but the fact that the company considers it cost-effective to hire a PR firm to promote the brand seems to indicate that I'm right.
    Do you have any idea of when the drug might be available in generic form? It would be very helpful to know that.

I'll let you know what he says back. I've also made a note to myself to find out at first opportunity whether I'm right about the insurance not helping if it goes OTC, but not generic. Finally, I've got a call in to the FDA to ask when Zyrtec will go generic. I realize those of you who don't need Zyrtec might not care about this in the narrowest sense, but I believe this situation is what English majors (or sociologists or economists or somebody) call a microcosm. Anyway, I'll be back to you as the plot sickens...