I'm allergic to everything. Dust, trees, grasses, molds, cockroaches, dust mites—you name it. And I've learned the hard way that taking a daily antihistamine—in my case, Zyrtec—is a necessity year round. Zyrtec is what my health insurance company calls a Tier 3 prescription drug, meaning a $50-a-month copay (or $100 every three months if I were disciplined enough to order my meds through my insurer's mail-order option). Because competitor Claritin is available over the counter, many insurers put Zyrtec, Clarinex, and Allegra into their highest-copayment categories.
So I was more than intrigued in November when the Food and Drug Administration approved Zyrtec for over-the-counter sale. Would I save money? Or pay more, assuming my insurer stops covering the drug? That's what many companies did when Claritin went OTC several years ago. A couple of phone calls indicated that they very likely will this time, too. WellPoint, which way back in 1998 asked the FDA to move Claritin, Allegra, and Zyrtec OTC, won't cover the OTC form of Zyrtec except in plans that include OTC medications, according to company spokesperson Jim Gavin. Aetna intends to stop, too.
While McNeil Consumer Healthcare, which makes the OTC form of Zyrtec, would not release pricing information, Drugstore.com gave me a sneak preview of how much the drug will probably cost when it hits store shelves later this month: $21.99 for a 30-day 10-milligram supply; Walgreens.com lists the same medicine for $2 more. (All forms of Zyrtec—including children's formulations and those with and without an added decongestant—will be OTC.) That compares with a $75.99 Drugstore.com price tag for prescription Zyrtec, or, in my case, $50. OTC generic options for Zyrtec are likely to be even cheaper.
People may also save on visits to the doctor once they don't need a prescription. Is that a benefit? "There's a debate [about] whether having a lot of patients bypass physicians for illnesses which present like allergies is a good thing," says Robert Fisher, a Wisconsin allergist. Still, he adds, a short trial of the drug, followed by a visit to the doctor if you're not getting better, "probably is safe and cost effective."