New Drug Combination

I believe that Psychiatric News crossed the line in the December 19, 2003, issue from news to advertising in its enthusiastic article about OFC, the Eli Lilly product that the FDA is expected to approve soon.

There is no doubt that an olanzapine-fluoxetine combination therapy is useful for many patients. However, combining the two medications in one pill appears to be a marketing technique, not an advance in patient care. Currently, we practicing psychiatrists can choose from a variety of olanzapine and fluoxetine dosage strengths and adjust each separately as needed for patient benefit. With the advent of generic fluoxetine this past year, self-pay patients and third-party payers alike have saved large amounts of money on patients who take this medication. And with more competition in the antipsychotic arena, even the cost of olanzapine has, thank goodness, decreased somewhat.

OFC does not appear to come in a great variety of dosage combinations (just three were mentioned in one of the Web abstracts). Additionally, neither the article nor the abstracts made any mention of cost. Thus, unless each combination is less expensive than two separate prescriptions for brand-name Zyprexa and generic fluoxetine, OFC will just be one more expensive, unnecessary drug in the marketplace.

Editor’s note: In view of the issues that Dr. Winslow raised, we contacted Eli Lilly and were given the following information: Symbyax is available in four strengths (mg olanzapine/mg fluoxetine): 6/25, 6/50, 12/25, and 12/50. The pricing of Symbyax is comparable, based on dosing, to Zyprexa alone. There is no additional cost for the fluoxetine component. Thus, the dosages with 6 mg of olanzapine will be priced similarly to 5 mg of Zyprexa, and 12 mg of olanzapine will be priced between 10 mg and 15 mg of Zyprexa.