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Florida Medicaid Antipsychotics 6
A St. Petersburg Times special report
Drug research: To test or to tout?
By Robert Farley, Times Staff Writer
April 13, 2008
The landscape had changed in the two years since the Florida Behavioral Health Collaborative set treatment guidelines favoring atypicals.
The CATIE study had been published. Tens of thousands of patients had sued drug companies that made atypicals. The academic community was more divided about what was best.
Last July, the collaborative convened another group of experts to revisit whether Florida should rely so heavily on atypicals. Two dozen mental health professionals met at the Renaissance Hotel at Tampa's International Plaza.
They gathered in the Kalamata Room, done up in the milquetoast style of a classic hotel meeting room: long tables arranged in a square, at each seat a glass of water and a name tag.
The bland setting belied the grand stakes: The vote could swing hundreds of millions of dollars in pharmaceutical company profits. Cost to taxpayers, however, had no place in the conversation.
The meeting's two main hosts were Rajiv Tandon, chief of psychiatry for the state Department of Children and Families, and Robert Constantine, head of the Florida Behavioral Health Collaborative.
Both believe in atypicals. In two papers they co-wrote in late 2006 and early 2007, they said the CATIE study missed the point: The goal is to create a good antipsychotic effect without the tremors, making atypicals the better choice.
Constantine, a research associate professor at USF's mental health institute, is partly paid through a grant from Bristol-Myers Squibb, which markets the atypical Abilify.
Tandon, a state employee, is not allowed to accept money from drug companies. But three years ago, before coming to Florida from the University of Michigan, he was a paid consultant and on the speaker's bureau for several drug companies that make atypicals.
It was Tandon who invited the four national experts to be voting members on the Florida panel. All are consultants, serve on speakers bureaus or get research support from the drug companies that profit from atypicals.
• William Glazer, who was brought in as the schizophrenia expert, is president of Glazer Medical Solutions, a national consortium of mental health care consultants. He is a consultant to Eli Lilly and AstraZeneca.
His company Web site makes clear his bias: "Are you interested in building a case for the value of new atypical antipsychotic medications? This section offers a step-wise approach to help providers, family members, consumers and others advocate for access to these agents."
• Madhukar Trivedi, a professor of psychiatry at the University of Texas Southwestern Medical Center, is a consultant, serves on speakers bureaus or receives research money from 24 pharmaceutical companies, including all the atypical makers.
• Terence Ketter, a professor of psychiatry and behavioral sciences and chief of the bipolar clinic at Stanford University, is a paid consultant or a lecturer for all the drug companies that make atypicals.
• John Greden, chairman of the psychiatry department at the University of Michigan Medical Center, serves on scientific advisory boards for five pharmaceutical companies, including two that make atypicals.
Tandon said he selected experts who are knowledgeable, respected leaders in their field, with a working knowledge of the medication guidelines process. Because most experts have ties to the pharmaceutical companies, Tandon said, conflicts of interest are inevitable.
"There are clear conflicts of interest," he said. "Everyone is biased. For someone to say, 'I'm not biased,' they are not truthful or they are not introspective."
Given that there is a divide in the academic world about atypicals, why not bring in someone from the other camp, maybe somebody from the CATIE study, someone who would challenge the existing medications model?
"You could go with extremes," Tandon said. "I didn't think that was the way to go," because the point of the process is to reach a consensus.
Atypicals are usually better, he said. "Were the benefits of atypical medications exaggerated? Absolutely. And was it the pharmaceutical companies doing that? Absolutely."
Still ... "By no means are the newer medications astoundingly better, but they are better. If I have a child, I'm not going to start them on a typical."
Length: 494
Rating: 0.00 (0 ratings)
Tags: florida ahca abilify geodon risperdal seroquel zyprexa atypical antipsychotics antipsychotic
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Harpool on Medicaid
Missouri state senate candidate Doug Harpool discusses cuts made to the state's Medicaid system.
Length: 69
Rating: 5.00 (1 ratings)
Tags: missouri politics springfield election
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Florida Medicaid Antipsychotics 4
Panel to review Medicaid guidelines for antipsychotic drugs
Daytona Beach News Journal
By M.C. MOEWE
May 30, 2008
A panel named this month to discuss changing state guidelines on paying for antipsychotic drugs for children will meet for the first time June 25.
At stake is the future treatment of more than 18,000 children in Florida currently receiving atypical antipsychotics medication for conditions ranging from ADHD to bipolar disorder and schizophrenia.
The number of children in the Florida Medicaid program prescribed the powerful drugs has nearly doubled from 9,364 kids in 2000 to 18,137 in 2006, the Daytona Beach News-Journal reported in January.
Among those children, the most common primary diagnosis was attention deficit hyperactivity disorder (ADHD) — an ailment not approved for treatment with antipsychotics by the Food and Drug Administration or by experts on the disease.
Medicaid will pay for a drug only if it is "medically necessary and prescribed for medically accepted indications," according to current state guidelines.
Former Florida Agency for Health Care Secretary Dr. Andrew Agwunobi created the review group in January. The panel's 11 members were announced this month, and officials said their recommendations will be presented to the agency's Pharmaceutical and Therapeutic Committee after the June 25 meeting.
Dr. Lisa Cosgrove, a Merritt Island pediatrician who is a member of the review group and committee, said she will rely on a state-funded study by the Medicaid Drug Therapy Management Program for Behavioral Health at the University of South Florida when making recommendations. "It's a good baseline model to follow," she said.
During that 2005 study, a panel of experts recommended that antipsychotics (some of these drugs include: Risperdal, Seroquel, Zyprex, Abilify and Geodon) should not be used primarily to target ADHD, nor should antipsychotics be given to children younger than age 6 except under the most extraordinary circumstances.
The review group's meeting will be 12:30 to 1:30 p.m. June 25 via teleconference.
Length: 567
Rating: 0.00 (0 ratings)
Tags: florida ahca abilify geodon risperdal seroquel zyprexa atypical antipsychotics antipsychotic
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Florida Medicaid Antipsychotics 7
Florida Medicaid To Review Antipsychotics & ADHD
By Ed Silverman
January 28th, 2008
The move comes amid growing scrutiny. The taxpayer bill for these meds jumped from $9 million seven years ago to nearly $30 million in 2006. Florida Medicaid records reportedly show the number of children - some just months old - who were prescribed the drugs went from 9,364 seven years ago to 18,137 in 2006. And even as drugmakers were being told to issue warnings about risks, a Florida Legislature-directed program partly funded by drugmakers was recommending the meds as treatment for ADHD, although FDA approval is lacking.
As a result, the Florida attorney general is considering whether to file a lawsuit. Now, the state's Agency for Health Care Administration is responding to concerns that the meds are being used inappropriately for treating ADHD, in particular, and will review coverage. The AHCA's own guidelines, by the way, state that "antipsychotics should not be used primarily to target ADHD symptoms, should not be used to promote weight gain, and should not be used as sedatives for children...and the use of antipsychotics in children under the age of six is generally not recommended."
Yet, a recent report by the University of South Florida found the most common diagnosis for antipsychotic treatment for youngsters in Florida's Medicaid program between July and December 2005 was for ADHD -and 54 percent involved children 5 years of age and younger, while 49 percent involved kids between ages 6 and 12 (please see table 5). And so nearly 40 percent of all antipsychotic scrips for youngsters were written for ADHD during that same period.
"We recognize that it may be necessary to review our long-standing guidelines in order to keep pace with evolving pharmacy science. AHCA secretary (Andrew) Agwunobi has requested the creation of a workgroup, under the Medical Care Advisory Committee, that will bring together experts in the field to determine if changes to our current policies are appropriate," an AHCA spokesman writes Pharmalot. "The group's findings will be presented to the Pharmaceutical and Therapeutic (P&T) Committee at their next meeting for their review and recommendations."
Length: 403
Rating: 5.00 (1 ratings)
Tags: florida ahca abilify geodon risperdal seroquel zyprexa atypical antipsychotics antipsychotic
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Florida Medicaid Antipsychotics 5
Florida Medicaid To Review Antipsychotics & ADHD
By Ed Silverman
January 28th, 2008
The move comes amid growing scrutiny. The taxpayer bill for these meds jumped from $9 million seven years ago to nearly $30 million in 2006. Florida Medicaid records reportedly show the number of children - some just months old - who were prescribed the drugs went from 9,364 seven years ago to 18,137 in 2006. And even as drugmakers were being told to issue warnings about risks, a Florida Legislature-directed program partly funded by drugmakers was recommending the meds as treatment for ADHD, although FDA approval is lacking.
As a result, the Florida attorney general is considering whether to file a lawsuit. Now, the state's Agency for Health Care Administration is responding to concerns that the meds are being used inappropriately for treating ADHD, in particular, and will review coverage. The AHCA's own guidelines, by the way, state that "antipsychotics should not be used primarily to target ADHD symptoms, should not be used to promote weight gain, and should not be used as sedatives for children...and the use of antipsychotics in children under the age of six is generally not recommended."
Yet, a recent report by the University of South Florida found the most common diagnosis for antipsychotic treatment for youngsters in Florida's Medicaid program between July and December 2005 was for ADHD -and 54 percent involved children 5 years of age and younger, while 49 percent involved kids between ages 6 and 12 (please see table 5). And so nearly 40 percent of all antipsychotic scrips for youngsters were written for ADHD during that same period.
"We recognize that it may be necessary to review our long-standing guidelines in order to keep pace with evolving pharmacy science. AHCA secretary (Andrew) Agwunobi has requested the creation of a workgroup, under the Medical Care Advisory Committee, that will bring together experts in the field to determine if changes to our current policies are appropriate," an AHCA spokesman writes Pharmalot. "The group's findings will be presented to the Pharmaceutical and Therapeutic (P&T) Committee at their next meeting for their review and recommendations."
Length: 572
Rating: 0.00 (0 ratings)
Tags: florida ahca abilify geodon risperdal seroquel zyprexa atypical antipsychotics antipsychotic
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$64 Billion Fraud in Medicaid
Medicaid, as matter of law, is always secondary to other insurance coverage. Taxpayers, through Medicaid nationally, are funding $64Billion in claims per year because their primacy system is not automated or centralized. Taxpayers need the states to follow the 1993 advice of the Workgroup on EDI by automating their primacy testing process so they can find other coverage when it's available, and enable medical providers to access this data, too.
HOW CAN YOU HELP?
Send us an email and we'll let you know what you can do to help:
FixMedicaid@yahoo.com
Length: 559
Rating: 0.00 (0 ratings)
Tags: Medicaid Fraud Solutions Government waste commentary analysis political commercial documentary grassroots outreach
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