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Study Shows Children With ADHD Who Start on Strattera are More,Likely to Change Therapies

Prime Therapeutics recommends clinical utilization management programs

ST. PAUL, Minn., April 10, 2007 /PRNewswire/ -- Pharmacy benefit manager Prime Therapeutics (Prime) today announced the results of a study on the utilization of Strattera(R) (atomoxetine) for treating attention deficit hyperactivity disorder (ADHD) in children. The study found that children who start on Strattera were 4.2 times more likely to change their therapy than children who started on stimulants. Due to these results and unique Strattera safety concerns, Prime has developed programs that promote the use of a stimulant drug prior to the use of Strattera. The results of this study will be presented at the 19th Annual American Managed Care Pharmacy (AMCP) Conference on April 13 in San Diego.

Because of Prime's close working relationship with many large health plans, Prime is uniquely positioned to analyze both pharmaceutical and medical data to closely monitor drug safety, efficacy, costs and prescribing practices. Prime pays close attention to the ADHD drug category because of safety concerns and the prevalent use of these drugs for treatment of children.

Prime's study involved the integration of medical and pharmacy claims for children in 2004 and 2005 from one Blue Cross and Blue Shield Plan with 1.8 million members. The study analyzed the use of Strattera and stimulants in children to determine how often children switched therapies. Strattera was found to be the first drug tried in one out of five children newly initiating therapy. The results showed that children who start on Strattera were 4.2 times more likely to subsequently change therapy than children who started on stimulants.

"We believe that children who start on Strattera are more likely to change therapies because they are experiencing side effects or the drug is not working effectively," said Patrick Gleason, PharmD, Director of Pharmacy and Medical I ntegration at Prime. "Because stimulants have been around longer and are available in generic forms, physicians and medical care providers have a lot more experience with them. They generally cost less and they don't have the suicidal ideation black box warning that Strattera has."

Gleason said the results suggest that when considering the unique Strattera safety concerns and possible lower effectiveness, stimulants may be a better, cost-effective alternative.

Through Prime's research, opportunities were identified for improved utilization management of Strattera. Prime developed a Strattera utilization program for its clients that calls for children to try a stimulant before Strattera. Prime also developed a Strattera prior authorization program for adults to encourage appropriate use. The goal of these programs is to ensure the safest and most effective therapy for patients while reducing prescription rework for physicians.

Strattera has a black box warning from the U.S. Food and Drug Administration (FDA) that indicates there is an increased risk of suicidal thoughts in children and adolescents with ADHD who take the drug. Additionally, a study published in the Journal of Attention Disorders in 2005 found that Strattera is less effective than stimulants in reducing the symptoms of ADHD. Other safety concerns, such as weight loss and increases in blood pressure and heart rate, exist with both Strattera and stimulants.

At the AMCP conference, Prime will also be presenting results of additional studies involving the integration of medical and pharmacy data including clinical utilization management program opportunities for infliximab and the fentanyl patch.

Prime Therapeutics LLC is a pharmacy benefit management company dedicated to providing innovative, clinically based, cost-effective pharmacy solutions for clients and members. Providing pharmacy benefit services nationwide to approximately 12.5 million covered lives, its client b ase includes Blue Cross and Blue Shield Plans, employer and union groups, and third-party administrators. Headquartered in St. Paul, Minnesota, Prime Therapeutics is collectively owned by Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those Plans. Learn more at

CONTACT: Jenna Thompson of Prime Therapeutics, +1-651-846-8461,

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