Good News For Allergy Sufferers: Blue Cross Blue Shield of Michigan And Blue Care Network Now Pay For Over-The-Counter Zyrtec

February 3, 2008

DETROIT - Blue Cross Blue Shield of Michigan and its affiliated HMO Blue Care Network began paying today for the over-the-counter version of Zyrtec®, a popular allergy medication, for their commercial members who have drug coverage. About 2 million Blue Cross members and all BCN members with drug coverage are eligible for the benefit.

The change will catch the attention of many allergy sufferers. Zyrtec is a widely used drug for relieving many indoor and outdoor allergy symptoms.

Zyrtec OTC is not approved for younger children, so pediatric formulations of Zyrtec and Zyrtec-D will continue to be available as prescription products.

Zyrtec OTC is available to Blue Cross members whose employers or groups have included this option in their benefit design. These members should check with their benefits administrator to confirm if their plan will cover Zyrtec OTC. All Blues members should consult with their physicians to confirm whether a change is right for them. Blues members who decide to make a change will still need to get a prescription from their doctor for Zyrtec OTC.

It is important to get a prescription. A Blues member could always purchase Zyrtec OTC at a pharmacy without a prescription, but the member would have to pay the retail price, and the cost would not be reimbursable by the Blues without a prescription.

Changing to Zyrtec OTC will save eligible Blues members money because they will be paying a generic copayment that's lower than the brand name copay required for prescription Zyrtec. The price for Zyrtec OTC is about 25 percent of the cost of the brand name medication. Blues members could save a total of $6 million annually in out-of-pocket costs, according to company estimates.

The savings for each individual member will depend on several variables, including copay levels and frequency of use. A Blues member whose monthly copay is $10 for a generic drug and $20 for a brand name drug could save $120 a year using Zyrtec OTC.

Participating employers could save nearly $10 million annually because the aggregate drug ingredient costs for Zyrtec OTC will be lower than the costs for the brand name, helping slow the growth of prescription drug cost trends.

Over the next three months, the Blues will be contacting members who fill prescriptions for Zyrtec, along with their physicians, and encouraging them to consider Zyrtec OTC or another lower cost alternative unless there is a medical reason not to do so.

"We encourage our members to discuss with their doctors whether a change to Zyrtec OTC is right for them," said Glen Perry, Blue Cross Blue Shield of Michigan director of pharmacy services. "This is another opportunity for Blues members and our customers to reduce costs."

Douglas R. Woll, M.D., senior vice president and chief medical officer for Blue Care Network, said, "Blue Care Network's decision to pay for Zyrtec OTC continues our pharmacy program's innovative efforts to keep costs down for members and customers while maintaining quality of care."

"The Blues' decision to pay for Zyrtec OTC is a welcome one," said Pietro A. Cavataio, M.D., a family practice physician in Marysville. "It is another step forward in making health care more affordable for employers and consumers while maintaining quality of care."

This is the second time in recent months that Blue Cross Blue Shield of Michigan has begun covering a major drug that moved to an over-the-counter version. Last fall, BCBSM began paying for Prilosec® OTC. Promoting effective but less costly over-the-counter alternatives is part of a series of concerted, ongoing efforts by the Blues to help keep prescription drug coverage as affordable as possible for employers and members. Since 2001, BCBSM has implemented programs to increase generic prescription drug use, saving Blues customers and members more than $500 million.

Additional information on how consumers can save money on prescription drugs can be found at a Web site launched by the Blues, theunadvertisedbrand.com.

About Blue Cross Blue Shield of Michigan
Blue Cross Blue Shield of Michigan, a nonprofit organization, provides and administers health benefits to more than 4.6 million members residing in Michigan in addition to members of Michigan-headquartered groups who reside outside the state. The company offers a broad variety of plans including: Traditional Blue Cross Blue Shield; Blue Preferred, Community Blue and Healthy Blue Incentives PPOs; Blue Care Network HMO; BCN Healthy Blue Living; Flexible Blue plans compatible with health savings accounts; Medicare Advantage; Part D Prescription Drug plans, and MyBlue products in the under-age-65 individual market. Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. http://www.bcbsm.com/index.shtml