Largest U.S. payor to continue covering Vytorin

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Despite clinical questions, UnitedHealth will cover Vytorin. Source: Maternity Insurance  

The UnitedHealth Group, the largest U.S. insurer, is recommending that patients stay on the cholesterol pill Vytorin, and the company will not charge a higher co-payment for Vytorin than for other brand-name cholesterol medicines because it has found “no safety issues” with the drug.

The decision signals confidence in a pill that a panel of cardiologists at the ACC08 conference said should not be used until patients try and fail with other drugs, according to the New York Times.

The combination of ezetimibe and simvastatin is marketed as Vytorin by its manufacturers, Merck and Schering-Plough.

Data unveiled from the Ezetimibe and Simvastatin in Hypercholesterolemia Enhances Atherosclerosis Regression (ENHANCE) trial found that the reduction of LDL cholesterol by the addition of ezetimibe to simvastatin did not reduce intima–media thickness of the carotid artery wall in patients with familial hypercholesterolemia. 

The NY Times reported that Schering-Plough has lost $21 billion in market value since a preliminary report on the study was released in January.

“There were no safety issues raised in January or now,” Brian Solow, medical director of clinical services at Prescription Solutions, UnitedHealth’s pharmacy group, told the NY Times. “The last thing we want to do is see patients stopping their medication when they need it.”

UnitedHealth, based in Minnetonka, Minn., charges the lowest co-payments for generics in insurance plans sold to patients enrolled in Medicare prescription plans. The second, more expensive pricing tier includes Vytorin and Pfizer’s Lipitor, reported the NY Times.

“Lipitor will accomplish the same goal as Vytorin,” Solow told the NY Times. The insurer has not required patients to try an alternate cholesterol-lowering drug before Vytorin in the past and has no plans to do so at this time, Solow said.

Vytorin and Zetia had more than $5 billion in sales last year, making them Schering’s most profitable product.