This is very-likely to be one of many states (and perhaps — the federal Medicaid system, itself, as well) to require “prior authorization” before Vytorin® may be submitted for reimbursement, by any doctor whose patient is a New York Medicaid recipient.
This probability was predicted by several writers in February 2008 (including the author of this blog). Consequently, it is unlikely that Vytorin® will ever again show significant quarter over quarter sales growth in the United States. This franchise (along with Zetia®) represents at least 50 percent of Schering’s expected 2008 profitability. It is hard to overstate the importance of this event. Buckle your chin-strap, Kenilworth — as Round Two of the Layoff Crash Car Derby is about to begin. . . .
An image of the actual page of the New York State Medicaid document
coming — in mere moments — here (click to enlarge):
NEW YORK STATE MEDICAID
PREFERRED DRUG LIST
All non-preferred drugs in these classes require prior authorization. . . .
HMG-CoA Reductase Inhibitors
Vytorin®. . . .
Oddly, Zetia — of which Vytorin is partially comprised — retains preferred status as an LDL lowering agent — but apparently not a CV outcomes-approved (Reductase Inhibitor) agent. I am actively seeking feedback on that portion of this event. Any comment? Any docs out there?
[All with a sincere, and huge, Hat Tip to Anonymous Commenter No. 24, at CafePharma.com, here.]