Following the release of the controversial Enhance trial, 85 pharmacy benefit managers and managed care execs haven’t indicated coverage will change, at least not until the full data is presented at the American College of Cardiology meeting at the end of March, according to a survey conducted by Cognet-X, a market research firm. The survey was conducted following the release of the data.

The trial, you may recall, found that the pricey cholesterol med failed to show any benefit over the much cheaper Zocor in reducing plaque in the carotid artery, and even showed a statistically insignificant buildup, although the pill did a better job of lowering LDL. The results prompted concern over the drug, which is sold by Merck and Schering-Plough, and a subsquent drop in prescriptions.

Two-thirds of those surveyed said immediate coverage changes for Vytorin and Zetia were unlikely, in part, because they were awaiting release and evaluation of full Enhance results; formulary design already promotes first-line use of the lower-priced generic Zocor; controls such as prior authorization and step therapy ensure appropriate use of Vytorin and Zetia (which along with Zocor comprises Vytorin); and Vytorin and Zetia were seen as having a place in therapy to lower cholesterol.

An Aetna spokeswoman echoed the results in a note sent to us recently: “Aetna has no plans to change coverage at this time. The recently published Enhance trial does not raise any new safety concerns. In addition, it is only one of many studies of the impact of cholesterol lowering drugs on various endpoints…We agree that this study is one piece of evidence, but not the whole story. Our pharmaceutical and therapeutics committee will consider all the evidence when reviewing drugs being considered for the preferred drug list.” And a Kaiser Permanente spokeswoman wrote to say: “Our use of Vytorin is limited as it is. We are leaving it on the formulary as a last line drug after statins as it has been for now.

UPDATE: In an investor note this morning, Deutsche Bank analyst Barbara Ryan writes: “We do not anticipate major changes in formulary positioning or usage patterns on the basis of these trial results.”

Of course, what happens at the ACC may crystallize their thinking.