Evaluation of Product Switching After a State Medicaid Program Began Covering Loratadine OTC 1 Year After Market Availability

Abstract

Medicaid recipients switched to another covered (Rx) LSA when loratadine became available as an OTC and was not covered. After the subsequent policy change 1 year later to cover loratadine OTC, there was little switching to loratadine OTC. Though the average cost per LSA claim dropped dollar 4.15 (6.6%), from dollar 62.79 in the baseline period to dollar 58.64 in the OTC coverage period, time-series and rate-ratio results suggest that an additional dollar 6.01 (10.2%) could have been saved per LSA claim had OTC coverage been in effect at the time of the conversion of loratadine to OTC status. Although coverage of loratadine OTC offers a substantial cost-savings opportunity for the Medicaid program compared with Rx-only LSAs, not covering the OTC product immediately at the time of OTC availability contributed to (a) increased switching to Rx-only LSA products and (b) little use of loratadine OTC in the subsequent OTC coverage period.