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New Research Bucks Common Perceptions Surrounding Rx-to-OTC Switches

Wolters Kluwer Health and The Nielsen Company released results of a joint study that go against conventional thinking about the dynamics when a prescription drug switches to over the counter

Using a new research paradigm that, for the first time, integrates prescription and over-the-counter (OTC) drug data, Wolters Kluwer Health and The Nielsen Company today 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.

Published today online ( by Nielsen and Wolters Kluwer Health, the study showcases overall patient trends surrounding the recent Zyrtec switch by utilizing HealthScape™ Consumer, the first truly integrated set of OTC/Rx informatics.

"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," said Nicholas Hall, Chairman and CEO of Nicholas Hall & Company, a leading 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."

Zyrtec OTC Consumers Willing to Pay More for Their Medication
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, etc.

"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."
Managed Care's Effect on Consumer Behavior

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," said Matt Dumas, Managing Director for NielsenHealth. "Although this study focuses on allergy, HealthScapeTM Consumer is helping clients in other markets impacted by Rx and OTC patient switching behavior including Upper GI, Pain, and Smoking Cessation."

According to Wolters Kluwer Health, $50 billion worth of prescription drugs are expected to go off patent by 2012, many of which will be candidates for OTC switches. As a result, integrated Rx/OTC informatics, such as HealthScapeTM, are going to become an important means of tracking success and failure as drug makers look for new ways to map consumer purchases and better understand the motivators behind those switching decisions.

Introduced in August 2008, HealthScape™ Consumer is the only longitudinal single-source informatics solution with both Rx and OTC transactional, attitudinal and behavioral consumer information. It utilizes sample counts that are twice as large as those used by traditional informatics and employs actual transaction data rather than survey results.

HealthScape™ is derived from the intersection of OTC purchase data and rich demographic information from Nielsen's Homescan® panel of 125,000 households and Wolters Kluwer Health's Source® Lx patient-level claims data, which comprises longitudinal patient medical and prescription data for 150 million patients. Data from both companies are matched through a proprietary encryption engine and de-identified in a HIPAA-compliant process. Combined, this produces a matched panel of more than 100,000 de-identified individuals for research.

The collaboration between the two companies, known as the Healthcare Consumer Informatics Alliance, brings together two of the most trusted and well-known data sources in the industry. The Alliance delivers consultative services and utilizes a joint consulting team comprised of experts from both companies for all of its client engagements.

For a free download of "Consumer Behavior and Managed Care Impact of the Zyrtec Rx-to-OTC Switch," the opportunity to register for our webinar on this topic, or to learn more about HealthScape™ Consumer, visit or email or

About Wolters Kluwer Health
Wolters Kluwer Health (Conshohocken, PA), a division of Wolters Kluwer, is a leading provider of information and business intelligence for students, professionals and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry. Major brands include traditional publishers of medical and drug reference tools and textbooks, such as Lippincott Williams & Wilkins and Facts & Comparisons® electronic information providers, such as Ovid, Medi-Span® and ProVation®; and pharmaceutical information providers such as Adis International and Source®. Wolters Kluwer Health has annual revenues (2007) of $1,044 million (€761 million) and employs approximately 2,700 employees globally. For more information,

About Wolters Kluwer
Wolters Kluwer is a leading global information services and publishing company. The company provides products and services globally for professionals in the health, tax, accounting, corporate, financial services, legal, and regulatory sectors. Wolters Kluwer has annual revenues (2007) of €3.4 billion ($4.8 billion), maintains operations in over 33 countries across Europe, North America, and Asia Pacific and employs approximately 19,500 people worldwide. Wolters Kluwer is headquartered in Amsterdam, the Netherlands. Visit for information about our market positions, customers, brands, and organization.

About NielsenHealth
NielsenHealth is a Nielsen Company service focusing on healthcare-related issues facing manufacturing, retail and media clients. The group takes a "consumer-centric" approach to critical targeting, marketing effectiveness and media related healthcare issues integrating The Nielsen Company's proprietary data and methodologies in the consumer and media space. For more information, please visit, .

About The Nielsen Company
The Nielsen Company is a global information and media company with leading marketing and consumer information, television and other media measurement, online intelligence, mobile measurement, trade shows and business publications (Billboard, The Hollywood Reporter, Adweek). The privately held company is active in more than 100 countries, with headquarters in New York, USA. For more information, please visit,