Patients with asthma or allergic rhinitis (nasal allergies), initially prescribed montelukast (Singulair) instead of typical first-line therapy have low rates of persistence on montelukast and may ultimately discontinue therapy altogether, according to a new study presented at the Academy of Managed Care Pharmacy’s 23rd Annual Meeting in Minneapolis, Minnesota. The study will be presented by Prime Therapeutics (Prime), a thought leader in pharmacy benefit management.

Montelukast is FDA-approved for treatment of asthma and allergic rhinitis. It works by inhibiting leukotrienes, the chemicals that cause inflammation. Montelukast is considered a second line of defence against asthma or allergic rhinitis. Typical first-line therapies are inhaled corticosteroids for asthma and nasal steroids for allergic rhinitis. The inhaled steroids act locally by concentrating their effects directly within the breathing passages, with very few side effects outside of the lungs or sinuses.

For the study, researchers identified 907 individuals with asthma who filled a claim for newly initiated montelukast therapy in the fourth quarter of 2009. An additional 373 people with allergic rhinitis or allergies who initiated montelukast therapy during the same time period were also identified. Patients were followed for 120 days after their first claim was filled to assess whether they continued to take montelukast after 30, 60, 90 and 120 days.

At 120 days after initiating montelukast therapy, 30.9 percent of asthma patients still had a supply of this medication. A similar poor persistence on montelukast treatment at 120 days was noted in patients with allergic rhinitis. In addition, at 120 days after montelukast was initiated, the vast majority of asthma and allergic rhinitis patients were lacking any therapy (62.6 and 64.9 percent, respectively).

“Continued drug treatment is essential for managing asthma,” said Patrick Gleason, PharmD, director of Clinical Outcomes Assessment at Prime. “This study suggests that utilization management programmes may be warranted to ensure that patients who start on montelukast have tried other first-line medications. Making sure patients take recommended medications first will help a greater number of patients manage their illness and will help save costs.”

Prime Therapeutics is a pharmacy benefit management company dedicated to providing innovative, clinically-based, cost-effective pharmacy solutions for clients and members.