Study on Zyrtec switch to OTC reveals unexpected conclusions

CONSHOHOCKEN, Pa. Using a new research paradigm that integrates prescription and over-the-counter drug data, Wolters Kluwer Health and The Nielsen Company on Monday released results of a joint study that go against conventional thinking about the dynamics when a prescription drug switches to OTC.

The Nielsen-Wolters Kluwer Health study entitled, “Consumer Behavior and Managed Care Impact of the Zyrtec Rx-to-OTC Switch,” reveals that a full 84 percent of those who switched to Zyrtec OTC were sourced from other OTC products rather than from other prescription products as many had expected. In fact, of all people who migrated to Zyrtec OTC from other allergy therapies, only 6 percent were former prescription Zyrtec users. Further, only 27 percent of prescription Zyrtec patients “followed the molecule” and switched to Zyrtec OTC.  

Focusing on allergy drug Zyrtec OTC and the spring 2008 allergy market, the study draws three key conclusions relating to the dynamics of a recent major OTC switch. First, it suggests that there was lower carryover from the base of prescription Zyrtec users than some expected. Second, switching to Zyrtec OTC led to increased spending on allergy medication for some consumers. And third, rather than restricting access to Rx drugs, managed care organizations may have actually helped to drive OTC utilization.

“Nielsen and Wolters Kluwer are breaking new ground here by providing the healthcare industry with important new information on consumer behavior and total healthcare purchase decisions in the context of a major Rx-to-OTC switch,” stated Nicholas Hall, chairman and chief executive officer of Nicholas Hall & Company, a business intelligence group tracking the global OTC market.  “If these newly-identified factors are corroborated in future research programs, marketers will be forced to re-evaluate the key drivers of an OTC switch, which could change and enhance marketing strategies over the coming decade.  In tomorrow’s recessive OTC market, manufacturers must be even more focused on consumer behavior, needs and expectations if a switch is to produce much needed new mega-brands.”

Another key finding suggests that, contrary to popular perceptions about OTCs being lower cost alternatives to prescriptions, most of those who switched to Zyrtec OTC actually paid more out of pocket versus their prior therapy.  

According to the data, 68 percent of consumers who switched to Zyrtec OTC paid more, with the average differential an $11.68 increase versus their prior therapy. This indicates that increased access to OTC may be more important than the cost of the therapies or medications.  It is important to note that this result reflects changes in consumer out-of-pocket medication expenses only and not the full treatment cost, e.g., office visits, diagnostic tests, the companies said.

“This is the first time anyone has looked at a medication market with Rx and OTC utilizations as a whole rather than as independent components,” said David Martin, vice president of sales and marketing, Wolters Kluwer Health. “What we found goes against preconceived notions about a brand switch to OTC. For one, it’s not safe to assume that a switch automatically leads to lower out-of-pocket for the patient.”

Authors of the study, Rick Crangle of Wolters Kluwer Health and Suzanne Chiaramonte of NielsenHealth, also examined how managed care may have influenced consumer actions in the allergy medication space. They discovered that although many MCOs did not influence consumer choice to utilize OTC alternatives by traditional means, such as rejections or changes to co-pays as was expected, a significant shift toward OTC amongst plan enrollees occurred nevertheless; furthermore, the shifts towards OTC treatment varied by managed care plan. Consumer targeted programs initiated by the plans themselves were cited as a probable cause showing the growing impact of managed care.

“By tracking the actual consumption related to Zyrtec, we’ve created the first true benchmark for an Rx-to-OTC switch challenging several industry perceptions and assumptions,” offered Matt Dumas, managing director for NielsenHealth. “Although this study focuses on allergy, HealthScape Consumer is helping clients in other markets impacted by Rx and OTC patient switching behavior including upper GI, pain, and smoking cessation.”