Feds Probe Antipsychotic Prescriptions For Children In Medicaid
In response to the rising rate at which antipsychotics are prescribed to children, the Office of Inspector General at the US Department of Health & Human Services is investigating the trend and asked the states to tighten prescribing oversight, The Wall Street Journal writes. The move comes amid ongoing that the drugs are used too freely to children to curb violent or aggressive behavior.
The issue, in fact, has been contentious for several years, especially before drugmakers won FDA approval to market their antipsychotics, which are approved to treat schizophrenia, bipolar disorder and autistic disorder, to increasingly younger children (back story). Since then, reports have emerged about outsized Medicaid spending in various states. Meanwhile, US Senator Chuck Grassley has periodically pressed all 50 states to release data on physicians who widely prescribe the medications, prompting some to take disciplinary action (back stories here and here).
Now, in recognition of the rising costs, HHS has picked up the thread. The agency wants to reduce “the unnecessarily high utilization,” Stephen Cha, a chief medical officer at the Centers for Medicare & Medicaid Services, tells the paper. Medicaid spends more on antipsychotics – including Eli Lilly’s (LLY) Zyprexa, Bristol-Myers Squibb's (BMY) Abilify, AstraZeneca’s (AZN) Seroquel and Johnson & Johnson’s (JNJ) Risperdal - than any other class of medicine.
In 2008, the most recent year for which data was available, spending was $3.6 billion, up from $1.6 billion in 1999, according to Mathematica Policy Research data cited by the paper. And the number of people younger than 20 years old who receive prescriptions for antipsychotics that are paid for by Medicaid tripled during that period.
The HHS probe is focusing on the five states with the largest Medicaid bills – California, Florida, Illinois, New York and Texas – and is examining prescribing trends between January through June 2011, the paper adds. During that time, the federal healthcare program paid for more than 84,600 prescriptions for antipsychotics for children who were 17 years old or younger.
And here is an interesting nugget that the OIG shared with the paper: so far, the probe has found that 482 children aged three or under were prescribed the drugs during that period, and this included 107 children who were two years old or less. And prescriptions for antipsychotics were written for six children who were less than a year old, including one who was listed as a one-month old.
Similar concerns have been noted concerning foster children. Two years ago, a study in Pediatrics found that foster kids were prescribed combinations of antipsychotics just as frequently as some of the most mentally disabled youngsters on Medicaid. About 2 percent of foster kids were given at least one antipsychotic, even though schizophrenia and bipolar disorder are very rare in young children.
The states that are the focus of the HHS probe, by the way, insist that prescribing guidelines are in place, the drugs were prescribed appropriately and that justifications were provided by physicians. Nonetheless, the paper points out that a Rutgers University study found that children on Medicaid are prescribed antipsychotics four times more often than those covered by private insurance.
This is not the only effort by the feds to crack down on inappropriate prescribing. Last November, the US Department of Justice filed a lawsuit against a psychiatrist for allegedly receiving illegal kickbacks from drugmakers and submitting false claims to Medicare and Medicaid for antipsychotics he prescribed for thousands of mentally ill patients in nursing homes. As we noted, the lawsuit marked one of the rare instances in which the feds went after a physician for violating the US False Claims Act (see this).
STORY ENDS HERE
The issue, in fact, has been contentious for several years, especially before drugmakers won FDA approval to market their antipsychotics, which are approved to treat schizophrenia, bipolar disorder and autistic disorder, to increasingly younger children (back story). Since then, reports have emerged about outsized Medicaid spending in various states. Meanwhile, US Senator Chuck Grassley has periodically pressed all 50 states to release data on physicians who widely prescribe the medications, prompting some to take disciplinary action (back stories here and here).
Now, in recognition of the rising costs, HHS has picked up the thread. The agency wants to reduce “the unnecessarily high utilization,” Stephen Cha, a chief medical officer at the Centers for Medicare & Medicaid Services, tells the paper. Medicaid spends more on antipsychotics – including Eli Lilly’s (LLY) Zyprexa, Bristol-Myers Squibb's (BMY) Abilify, AstraZeneca’s (AZN) Seroquel and Johnson & Johnson’s (JNJ) Risperdal - than any other class of medicine.
In 2008, the most recent year for which data was available, spending was $3.6 billion, up from $1.6 billion in 1999, according to Mathematica Policy Research data cited by the paper. And the number of people younger than 20 years old who receive prescriptions for antipsychotics that are paid for by Medicaid tripled during that period.
The HHS probe is focusing on the five states with the largest Medicaid bills – California, Florida, Illinois, New York and Texas – and is examining prescribing trends between January through June 2011, the paper adds. During that time, the federal healthcare program paid for more than 84,600 prescriptions for antipsychotics for children who were 17 years old or younger.
And here is an interesting nugget that the OIG shared with the paper: so far, the probe has found that 482 children aged three or under were prescribed the drugs during that period, and this included 107 children who were two years old or less. And prescriptions for antipsychotics were written for six children who were less than a year old, including one who was listed as a one-month old.
Similar concerns have been noted concerning foster children. Two years ago, a study in Pediatrics found that foster kids were prescribed combinations of antipsychotics just as frequently as some of the most mentally disabled youngsters on Medicaid. About 2 percent of foster kids were given at least one antipsychotic, even though schizophrenia and bipolar disorder are very rare in young children.
The states that are the focus of the HHS probe, by the way, insist that prescribing guidelines are in place, the drugs were prescribed appropriately and that justifications were provided by physicians. Nonetheless, the paper points out that a Rutgers University study found that children on Medicaid are prescribed antipsychotics four times more often than those covered by private insurance.
This is not the only effort by the feds to crack down on inappropriate prescribing. Last November, the US Department of Justice filed a lawsuit against a psychiatrist for allegedly receiving illegal kickbacks from drugmakers and submitting false claims to Medicare and Medicaid for antipsychotics he prescribed for thousands of mentally ill patients in nursing homes. As we noted, the lawsuit marked one of the rare instances in which the feds went after a physician for violating the US False Claims Act (see this).
STORY ENDS HERE
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