Study: Medicaid patients get wrong drugs

Drugs designed to treat severe mental illnesses are being prescribed to Medicaid patients at inappropriately low doses, at considerable expense and for conditions where their benefits haven't been proven, a team of mostly Oregon researchers reports.

Scientists from the Oregon State University College of Pharmacy, Oregon Health and Science University and Columbia University's psychiatry department reviewed records for 830 Oregon Medicaid patients who had been given antipsychotic medications approved for conditions such as schizophrenia and bipolar disorder. The researchers found the majority of those patients did not have the underlying mental conditions for which the drugs were approved for prescription. Instead, they were given to patients to treat health concerns such as depression, anxiety, post-traumatic stress disorder or insomnia.

READ MORE @ STATESMAN JOURNAL

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).

READ MORE @ PHARMALOT

AP IMPACT: Govt pays for risky unapproved drugs

The government is paying millions for risky medications that have never been reviewed for safety and effectiveness but are still covered under Medicaid, an Associated Press analysis of federal data has found.

Taxpayers have shelled out at least $200 million since 2004 for such drugs. Yet the Food and Drug Administration says unapproved prescription drugs are a public health problem, and some unapproved medications have been linked to dozens of deaths.

Millions of private patients are taking them as well, and their availability may create a false sense of security.

The AP analysis found that Medicaid, which serves low-income people, paid nearly $198 million from 2004 to 2007 for more than 100 unapproved drugs. Data for 2008 were not available but unapproved drugs still are being sold. The AP checked the medications against FDA databases, using agency guidelines to determine if they were unapproved. The FDA says there may be thousands of such drugs on the market.

READ MORE @ AP

Moody Is the New Bipolar

In Eugene Jarecki's documentary film Why We Fight, about the U.S. military-industrial complex, U.S. foreign policy critic Chalmers Johnson states: "I guarantee you when war becomes that profitable, you are going to see more of it." Similarly, as mental illness has become extremely profitable, we are seeing more of it.

On September 4, 2007, the New York Times reported, "The number of American children and adolescents treated for bipolar disorder increased 40-fold from 1994 to 2003 ... Drug makers and company-sponsored psychiatrists have been encouraging doctors to look for the disorder."

Not too long ago, a child who was irritable, moody, and distractible and who at times sounded grandiose or acted without regard for consequences was considered a "handful." In the U.S. by the 1980s, that child was labeled with a "behavioral disorder" and today that child is being diagnosed as "bipolar" and "psychotic" -- and prescribed expensive antipsychotic drugs. Bloomberg News, also on September 4, 2007, reported, "The expanded use of bipolar as a pediatric diagnosis has made children the fastest-growing part of the $11.5 billion U.S. market for antipsychotic drugs."

READ MORE @ ALTERNET

Medicaid Recipients Have Trouble Finding Mental Health Care

Medicaid beneficiaries with substance abuse and mental disorders are less likely to use community services, even though most of the medical help for these disorders is community-based, a new study finds.

The study, which is published in the July issue of Psychiatric Services, examined where integrated treatments for co-occurring psychiatric and substance abuse disorders would be most needed for Medicaid recipients.

Psychiatric and substance abuse disorders are a major problem among the Medicaid population, which has 50 percent to 100 percent more cases than the general population.

Previous research has suggested that community-based treatment for these disorders is superior to treatment in hospitals, with the continuity of treatment being weaker and costs being higher in hospital settings. Because of this, care providers have focused on providing intervention programs in community settings, such as clinics and therapists' offices.

READ MORE @ FORBES