Psych Patients With Cost-Sharing Plans Use More Services

People whose insurance plans better share the burden of the cost for mental health services use these programs more than those whose plans pick up less of the bill, a new study says.

The findings were based on a study of Medicare patients, some of whose plans provided equal cost-sharing and others whose plans put a greater cost burden on the patients. The patients in the study had recently received psychiatric discharges from facilities.

The study was published in the Dec. 24/31 issue of Journal of the American Medical Association.

U.S. health insurers have historically imposed higher out-of-pocket costs and greater restrictions for the use of mental health services than other medical illnesses.

READ MORE @ WASHINGTON POST

Practicing Patients

Todd Small was stuck in quicksand again. It happened, as always, on the floor of the Seattle machine shop where he worked. His shift complete, Small was making the 150-yard walk from his workstation to his car, when he realized that his left leg was sinking deep in the stuff. Though this had happened before — it happened nearly every day now — he stopped and glanced down at his feet. His Nikes looked normal, still firmly planted on the shop’s concrete floor. But he was stuck, just the same. His brain was sending an electrical pulse saying “walk,” but as the signal streaked from his cerebellum and down his spinal cord, it snagged on scar tissue where the myelin layer insulating his nerve fibers had broken down. The message wasn’t getting to his hip flexors or his hamstrings or his left foot. That connection had been severed by his multiple sclerosis. And once again, Small was left with the feeling that, as he described it, “I’m up to my waist in quicksand.”

For the 400,000 Americans with multiple sclerosis, Todd Small’s description will most likely ring true. Muscle stiffness is a hallmark of the disease, and “foot drop” — the term for Small’s quicksand feeling — is a frequent complaint. The condition is usually treated, as it was in Small’s case, with baclofen, a muscle relaxant that works directly on the spinal cord. Every day for 14 years, he took a single 10-milligram pill. “My neurologist always told me if you take too much it will weaken your muscles. So I never wanted to go over 10 milligrams.” It didn’t seem to have much effect, but he carried on as best he could.

Small would have continued just as he was had he not logged on last June to a Web site called PatientsLikeMe. He expected the sort of online community he’d tried and abandoned several times before — one abundant in sympathy and stories but thin on practical information. But he found something altogether different: data.

READ MORE @ NY TIMES

Carbamazepine Gets Warning on Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis

Carbamazepine, a drug used to treat epilepsy and bipolar disorder, will now come with new warnings that Asian patients should undergo genetic testing before using the drug. According to the Food & Drug Administration (FDA), a human leukocyte antigen called HLA-B*1502 that is exclusive to people with Asian ancestry makes it more likely that carbamazepine will cause the serious skin disorders Stevens-Johnson Syndrome and toxic epidermal necrolysis.

Carbamazepine is an anticonvulsant and mood stabilizing drug, used primarily in the treatment of epilepsy and bipolar disorder. It is also used to treat other disorders, including Attention Deficit Hyperactivity Disorder and schizophrenia. It is sold under the brand names Carbatrol, Equetro and Tegretol.

READ MORE @ NEWS INFERNO