Monday, December 22, 2008

Florida Medicaid, Antipsychotics and Small Children

At a time when growing use of atypical antipyschotics in children is under a microscope, Florida’s Medicaid program recently revised rules that makes it possible for doctors to write prescriptions for children of all ages - including those younger than six years old.

Most of these drugs can lead to weight gain and diabetes, and one prominent study found they were no more effective than older meds. Yet the drugs are increasingly prescribed for children, with Medicaid programs in several states reporting rising expenditures for antipsychotics, sometimes to treat ADD or ADHD, which are unapproved uses (look here and here).

In general, the atypical antipsychotics - a newer class that includes AstraZeneca’s Seroquel; Bristol-Myers Squibb’s Abilify; Pfizer’s Geodon; Lilly’s Zyprexa and Johnson & Johnson’s Risperdal - were not approved by the FDA to treat small children, or those younger than 10 years old. Risperdal has been approved for children older than 5 years of age, but only for those with autistic disorder. To be eligible for Medicaid reimbursement, a drug has to be used for a medically accepted indication, which means the drug has to be approved for a specific use or supported by specific compendia (this link indicates the three compendia do not list any use of the atypicals in children younger than 5 years old).


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