NAMI exposed again - Drug companies enlist advocates' aid

[Guest guest]

http://www.tennessean.com/business/archives/04/03/47893111.shtml?Element_ID=4789\

3111

Sunday, 03/07/04

Drug companies enlist advocates' aid

By BILL LEWIS

Staff Writer

Gov. Phil Bredesen stepped into a national storm when he said TennCare should

stop paying millions of dollars for Eli Lilly's blockbuster anti-psychotic drug

Zyprexa and restrict access to other prescription drugs.

At least 41 states, including Tennessee, have taken steps to create

preferred-drug lists, which encourage doctors to prescribe some drugs but not

others. Drug companies are not happy about that, and advocacy groups fear

vulnerable Medicare enrollees won't get the medications they need.

Of the 10 drugs that TennCare spent the most money on in the last half of 2003,

three of those - Zyprexa, Wyeth's Protonix and Tap Pharmaceutical's Prevacid -

would not be purchased under Bredesen's proposal to control costs.

The stakes are high for drug companies such as Lilly. Sales of Zyprexa reached

$4.3 billion last year, according to press reports, and accounted for one-third

of Lilly's sales.

TennCare paid $33.3 million for 111,370 Zyprexa prescriptions in the last half

of 2003. TennCare paid more for Zyprexa than for any other drug.

Bredesen wants TennCare to stop paying $5.47 for each dose of Zyprexa and

instead buy an alternative treatment that costs 33 cents per dose.

Lilly also faces problems in Texas, where the state removed Zyprexa from its

preferred-drug list for its Medicaid program.

''We don't agree with restricted access,'' said Anne , spokeswoman for

Lilly.

But the drug companies are not visibly opposing Bredesen. said last week

that it is a coincidence that Lilly and other drug companies gave $60,000 to a

coalition of mental health groups planning to lobby the legislature against

Bredesen's proposal during a ''day on the Hill'' at the state Capitol on March

16. The drug companies' funding accounts for 80% of the budget of the Tennessee

Coalition of Mental Health and Substance Abuse Services, said Anita Bertrand,

executive director of the Mental Health Association of Tennessee.

The coalition, which opposes any restrictions on the availability of

prescription drugs, realizes Bredesen might criticize it for taking money from

the drug companies, Bertrand said.

''What are we going to say to them, 'We're not going to take your money because

the governor is going to be upset?' '' she asked. ''We're not backing down.''

The coalition of about 20 advocacy groups is fighting Bredesen's plan to limit

the number of prescriptions TennCare enrollees can fill each month, to require

use of generic drugs instead of name-brand drugs, and to stop buying

prescription allergy and gastric acid remedies altogether.

When he outlined his plan for lawmakers last month, Bredesen warned them to

expect ''so-called grass-roots efforts'' to derail his proposal.

, though, said the coalition's ''day on the Hill'' had been planned since

last year, long before Bredesen's speech last month.

''Obviously this is not a reaction to Bredesen's recent proposal. I think the

timing just worked out that it's following his announcement. I don't think we

could have predicted what his proposal was going to be. If so, that's news to

me,'' she said.

In addition to Lilly, three pharmaceutical companies that gave money to the

mental health coalition that opposes Bredesen also manufacture some of the drugs

that TennCare spends the most money on.

AstraZeneca makes the schizophrenia drug Seroquel, which cost TennCare $16.4

million in the last half of 2003. Janssen makes Risperdal. TennCare paid $13

million for that drug between June and November 2003. Pfizer makes Zoloft, an

anti-depression drug that TennCare spent almost $13 million on over six months

in 2003. All three companies support the coalition, Bertrand said.

The pharmaceutical company Wyeth has two drugs on the top 10 list. In addition

to Protonix, the gastric acid drug that Bredesen said TennCare should no longer

buy, Wyeth makes Effexor, which treats depression and anxiety.

Wyeth is not reacting publicly to Bredesen's plan to crack down on TennCare's

drug costs.

''We're not going to be able to comment on this situation,'' Wyeth spokesman

Doug Petkus said.

TennCare's pharmacy costs are expected to be more than $2.3 billion this year,

which is more than the state spends on higher education. Bredesen said all of

the changes he wants to make would save $2.5 billion over four years.

If its spending is not controlled, TennCare will absorb nearly every dollar in

new revenue the state collects between now and 2008, leaving little money for

other priorities. That conclusion was reached by McKinsey & Co., the consulting

company commissioned to take an independent look at the program.

TennCare's total cost today is $6.9 billion. The state's share is $2.1 billion.

The federal government finances the rest. By 2008, the program's total costs

could be $12.2 billion with the state's share rising to $3.8 billion, the

McKinsey report concluded.

In addition to limiting each enrollee's prescriptions to six a month, Bredesen

wants to limit doctor visits to 10 a year and require co-payments.

Those limits would affect about one-third of TennCare's 1.3 million enrollees,

whom Bredesen described as ''able bodied.'' They would not apply to 859,000

pregnant women, children or disabled people, including some individuals with

mental illness or HIV/AIDS.

Everyone, though, would be expected to use the lowest-cost prescription drugs,

although some patients with mental illness would be allowed to continue with

their current drug therapies.

Using generics instead of name-brand drugs can result in big savings. BlueCross

BlueShield of Tennessee, the Chattanooga-based nonprofit insurance company,

increased the use of generics 1.3% last year and saved $5.3 million, spokesman

Bill Steverson said. Savings were also passed on to policy holders.

''$5 million is definitely nothing to sneeze at,'' he said.

A pharmacy advisory board is in the process of writing Tennessee's

preferred-drug list. Cost is not the only reason a drug would be included on the

list, TennCare spokeswoman Marilyn Elam said. Medications on the preferred-drug

list have to be as effective as those that are taken off.

''Equally effective is the first standard,'' she said. ''If it's cheaper but

doesn't work as effectively, that's not the answer.''

Advocates for patients who rely on mental health services aren't convinced that

drugs that wind up on a preferred-drug list are as effective as those that

don't.

''We've been fighting these battles in many states,'' said Bright,

spokeswoman for the National Mental Health Association.

The association receives funding from the pharmaceutical industry, the federal

government and private foundations, she said.

The source of funding does not affect the association's disturbing conclusions,

Bright said. ''No state is looking at how this affects patient health.''

Bredesen thinks he can control costs and protect patients at the same time. The

public battle that decides whether he gets the chance begins March 16, when the

mental health advocates get their day on the Hill, with the help of the drug

companies.

© Copyright 2002 The Tennessean

A Gannett Co. Inc. newspaper Use of this site signifies that you agree to

our terms of service (updated: 08/01/2001).

Associated Press content is Copyrighted by The Associated Press.

Jim - Norman

" Never look at the trombones, it only encourages them. "

Strauss

[Guest guest]

http://www.tennessean.com/business/archives/04/03/47893111.shtml?Element_ID=4789\

3111

Sunday, 03/07/04

Drug companies enlist advocates' aid

By BILL LEWIS

Staff Writer

Gov. Phil Bredesen stepped into a national storm when he said TennCare should

stop paying millions of dollars for Eli Lilly's blockbuster anti-psychotic drug

Zyprexa and restrict access to other prescription drugs.

At least 41 states, including Tennessee, have taken steps to create

preferred-drug lists, which encourage doctors to prescribe some drugs but not

others. Drug companies are not happy about that, and advocacy groups fear

vulnerable Medicare enrollees won't get the medications they need.

Of the 10 drugs that TennCare spent the most money on in the last half of 2003,

three of those - Zyprexa, Wyeth's Protonix and Tap Pharmaceutical's Prevacid -

would not be purchased under Bredesen's proposal to control costs.

The stakes are high for drug companies such as Lilly. Sales of Zyprexa reached

$4.3 billion last year, according to press reports, and accounted for one-third

of Lilly's sales.

TennCare paid $33.3 million for 111,370 Zyprexa prescriptions in the last half

of 2003. TennCare paid more for Zyprexa than for any other drug.

Bredesen wants TennCare to stop paying $5.47 for each dose of Zyprexa and

instead buy an alternative treatment that costs 33 cents per dose.

Lilly also faces problems in Texas, where the state removed Zyprexa from its

preferred-drug list for its Medicaid program.

''We don't agree with restricted access,'' said Anne , spokeswoman for

Lilly.

But the drug companies are not visibly opposing Bredesen. said last week

that it is a coincidence that Lilly and other drug companies gave $60,000 to a

coalition of mental health groups planning to lobby the legislature against

Bredesen's proposal during a ''day on the Hill'' at the state Capitol on March

16. The drug companies' funding accounts for 80% of the budget of the Tennessee

Coalition of Mental Health and Substance Abuse Services, said Anita Bertrand,

executive director of the Mental Health Association of Tennessee.

The coalition, which opposes any restrictions on the availability of

prescription drugs, realizes Bredesen might criticize it for taking money from

the drug companies, Bertrand said.

''What are we going to say to them, 'We're not going to take your money because

the governor is going to be upset?' '' she asked. ''We're not backing down.''

The coalition of about 20 advocacy groups is fighting Bredesen's plan to limit

the number of prescriptions TennCare enrollees can fill each month, to require

use of generic drugs instead of name-brand drugs, and to stop buying

prescription allergy and gastric acid remedies altogether.

When he outlined his plan for lawmakers last month, Bredesen warned them to

expect ''so-called grass-roots efforts'' to derail his proposal.

, though, said the coalition's ''day on the Hill'' had been planned since

last year, long before Bredesen's speech last month.

''Obviously this is not a reaction to Bredesen's recent proposal. I think the

timing just worked out that it's following his announcement. I don't think we

could have predicted what his proposal was going to be. If so, that's news to

me,'' she said.

In addition to Lilly, three pharmaceutical companies that gave money to the

mental health coalition that opposes Bredesen also manufacture some of the drugs

that TennCare spends the most money on.

AstraZeneca makes the schizophrenia drug Seroquel, which cost TennCare $16.4

million in the last half of 2003. Janssen makes Risperdal. TennCare paid $13

million for that drug between June and November 2003. Pfizer makes Zoloft, an

anti-depression drug that TennCare spent almost $13 million on over six months

in 2003. All three companies support the coalition, Bertrand said.

The pharmaceutical company Wyeth has two drugs on the top 10 list. In addition

to Protonix, the gastric acid drug that Bredesen said TennCare should no longer

buy, Wyeth makes Effexor, which treats depression and anxiety.

Wyeth is not reacting publicly to Bredesen's plan to crack down on TennCare's

drug costs.

''We're not going to be able to comment on this situation,'' Wyeth spokesman

Doug Petkus said.

TennCare's pharmacy costs are expected to be more than $2.3 billion this year,

which is more than the state spends on higher education. Bredesen said all of

the changes he wants to make would save $2.5 billion over four years.

If its spending is not controlled, TennCare will absorb nearly every dollar in

new revenue the state collects between now and 2008, leaving little money for

other priorities. That conclusion was reached by McKinsey & Co., the consulting

company commissioned to take an independent look at the program.

TennCare's total cost today is $6.9 billion. The state's share is $2.1 billion.

The federal government finances the rest. By 2008, the program's total costs

could be $12.2 billion with the state's share rising to $3.8 billion, the

McKinsey report concluded.

In addition to limiting each enrollee's prescriptions to six a month, Bredesen

wants to limit doctor visits to 10 a year and require co-payments.

Those limits would affect about one-third of TennCare's 1.3 million enrollees,

whom Bredesen described as ''able bodied.'' They would not apply to 859,000

pregnant women, children or disabled people, including some individuals with

mental illness or HIV/AIDS.

Everyone, though, would be expected to use the lowest-cost prescription drugs,

although some patients with mental illness would be allowed to continue with

their current drug therapies.

Using generics instead of name-brand drugs can result in big savings. BlueCross

BlueShield of Tennessee, the Chattanooga-based nonprofit insurance company,

increased the use of generics 1.3% last year and saved $5.3 million, spokesman

Bill Steverson said. Savings were also passed on to policy holders.

''$5 million is definitely nothing to sneeze at,'' he said.

A pharmacy advisory board is in the process of writing Tennessee's

preferred-drug list. Cost is not the only reason a drug would be included on the

list, TennCare spokeswoman Marilyn Elam said. Medications on the preferred-drug

list have to be as effective as those that are taken off.

''Equally effective is the first standard,'' she said. ''If it's cheaper but

doesn't work as effectively, that's not the answer.''

Advocates for patients who rely on mental health services aren't convinced that

drugs that wind up on a preferred-drug list are as effective as those that

don't.

''We've been fighting these battles in many states,'' said Bright,

spokeswoman for the National Mental Health Association.

The association receives funding from the pharmaceutical industry, the federal

government and private foundations, she said.

The source of funding does not affect the association's disturbing conclusions,

Bright said. ''No state is looking at how this affects patient health.''

Bredesen thinks he can control costs and protect patients at the same time. The

public battle that decides whether he gets the chance begins March 16, when the

mental health advocates get their day on the Hill, with the help of the drug

companies.

© Copyright 2002 The Tennessean

A Gannett Co. Inc. newspaper Use of this site signifies that you agree to

our terms of service (updated: 08/01/2001).

Associated Press content is Copyrighted by The Associated Press.

Jim - Norman

" Never look at the trombones, it only encourages them. "

Strauss

[Guest guest]

http://www.tennessean.com/business/archives/04/03/47893111.shtml?Element_ID=4789\

3111

Sunday, 03/07/04

Drug companies enlist advocates' aid

By BILL LEWIS

Staff Writer

Gov. Phil Bredesen stepped into a national storm when he said TennCare should

stop paying millions of dollars for Eli Lilly's blockbuster anti-psychotic drug

Zyprexa and restrict access to other prescription drugs.

At least 41 states, including Tennessee, have taken steps to create

preferred-drug lists, which encourage doctors to prescribe some drugs but not

others. Drug companies are not happy about that, and advocacy groups fear

vulnerable Medicare enrollees won't get the medications they need.

Of the 10 drugs that TennCare spent the most money on in the last half of 2003,

three of those - Zyprexa, Wyeth's Protonix and Tap Pharmaceutical's Prevacid -

would not be purchased under Bredesen's proposal to control costs.

The stakes are high for drug companies such as Lilly. Sales of Zyprexa reached

$4.3 billion last year, according to press reports, and accounted for one-third

of Lilly's sales.

TennCare paid $33.3 million for 111,370 Zyprexa prescriptions in the last half

of 2003. TennCare paid more for Zyprexa than for any other drug.

Bredesen wants TennCare to stop paying $5.47 for each dose of Zyprexa and

instead buy an alternative treatment that costs 33 cents per dose.

Lilly also faces problems in Texas, where the state removed Zyprexa from its

preferred-drug list for its Medicaid program.

''We don't agree with restricted access,'' said Anne , spokeswoman for

Lilly.

But the drug companies are not visibly opposing Bredesen. said last week

that it is a coincidence that Lilly and other drug companies gave $60,000 to a

coalition of mental health groups planning to lobby the legislature against

Bredesen's proposal during a ''day on the Hill'' at the state Capitol on March

16. The drug companies' funding accounts for 80% of the budget of the Tennessee

Coalition of Mental Health and Substance Abuse Services, said Anita Bertrand,

executive director of the Mental Health Association of Tennessee.

The coalition, which opposes any restrictions on the availability of

prescription drugs, realizes Bredesen might criticize it for taking money from

the drug companies, Bertrand said.

''What are we going to say to them, 'We're not going to take your money because

the governor is going to be upset?' '' she asked. ''We're not backing down.''

The coalition of about 20 advocacy groups is fighting Bredesen's plan to limit

the number of prescriptions TennCare enrollees can fill each month, to require

use of generic drugs instead of name-brand drugs, and to stop buying

prescription allergy and gastric acid remedies altogether.

When he outlined his plan for lawmakers last month, Bredesen warned them to

expect ''so-called grass-roots efforts'' to derail his proposal.

, though, said the coalition's ''day on the Hill'' had been planned since

last year, long before Bredesen's speech last month.

''Obviously this is not a reaction to Bredesen's recent proposal. I think the

timing just worked out that it's following his announcement. I don't think we

could have predicted what his proposal was going to be. If so, that's news to

me,'' she said.

In addition to Lilly, three pharmaceutical companies that gave money to the

mental health coalition that opposes Bredesen also manufacture some of the drugs

that TennCare spends the most money on.

AstraZeneca makes the schizophrenia drug Seroquel, which cost TennCare $16.4

million in the last half of 2003. Janssen makes Risperdal. TennCare paid $13

million for that drug between June and November 2003. Pfizer makes Zoloft, an

anti-depression drug that TennCare spent almost $13 million on over six months

in 2003. All three companies support the coalition, Bertrand said.

The pharmaceutical company Wyeth has two drugs on the top 10 list. In addition

to Protonix, the gastric acid drug that Bredesen said TennCare should no longer

buy, Wyeth makes Effexor, which treats depression and anxiety.

Wyeth is not reacting publicly to Bredesen's plan to crack down on TennCare's

drug costs.

''We're not going to be able to comment on this situation,'' Wyeth spokesman

Doug Petkus said.

TennCare's pharmacy costs are expected to be more than $2.3 billion this year,

which is more than the state spends on higher education. Bredesen said all of

the changes he wants to make would save $2.5 billion over four years.

If its spending is not controlled, TennCare will absorb nearly every dollar in

new revenue the state collects between now and 2008, leaving little money for

other priorities. That conclusion was reached by McKinsey & Co., the consulting

company commissioned to take an independent look at the program.

TennCare's total cost today is $6.9 billion. The state's share is $2.1 billion.

The federal government finances the rest. By 2008, the program's total costs

could be $12.2 billion with the state's share rising to $3.8 billion, the

McKinsey report concluded.

In addition to limiting each enrollee's prescriptions to six a month, Bredesen

wants to limit doctor visits to 10 a year and require co-payments.

Those limits would affect about one-third of TennCare's 1.3 million enrollees,

whom Bredesen described as ''able bodied.'' They would not apply to 859,000

pregnant women, children or disabled people, including some individuals with

mental illness or HIV/AIDS.

Everyone, though, would be expected to use the lowest-cost prescription drugs,

although some patients with mental illness would be allowed to continue with

their current drug therapies.

Using generics instead of name-brand drugs can result in big savings. BlueCross

BlueShield of Tennessee, the Chattanooga-based nonprofit insurance company,

increased the use of generics 1.3% last year and saved $5.3 million, spokesman

Bill Steverson said. Savings were also passed on to policy holders.

''$5 million is definitely nothing to sneeze at,'' he said.

A pharmacy advisory board is in the process of writing Tennessee's

preferred-drug list. Cost is not the only reason a drug would be included on the

list, TennCare spokeswoman Marilyn Elam said. Medications on the preferred-drug

list have to be as effective as those that are taken off.

''Equally effective is the first standard,'' she said. ''If it's cheaper but

doesn't work as effectively, that's not the answer.''

Advocates for patients who rely on mental health services aren't convinced that

drugs that wind up on a preferred-drug list are as effective as those that

don't.

''We've been fighting these battles in many states,'' said Bright,

spokeswoman for the National Mental Health Association.

The association receives funding from the pharmaceutical industry, the federal

government and private foundations, she said.

The source of funding does not affect the association's disturbing conclusions,

Bright said. ''No state is looking at how this affects patient health.''

Bredesen thinks he can control costs and protect patients at the same time. The

public battle that decides whether he gets the chance begins March 16, when the

mental health advocates get their day on the Hill, with the help of the drug

companies.

© Copyright 2002 The Tennessean

A Gannett Co. Inc. newspaper Use of this site signifies that you agree to

our terms of service (updated: 08/01/2001).

Associated Press content is Copyrighted by The Associated Press.

Jim - Norman

" Never look at the trombones, it only encourages them. "

Strauss

[Guest guest]

http://www.tennessean.com/business/archives/04/03/47893111.shtml?Element_ID=4789\

3111

Sunday, 03/07/04

Drug companies enlist advocates' aid

By BILL LEWIS

Staff Writer

Gov. Phil Bredesen stepped into a national storm when he said TennCare should

stop paying millions of dollars for Eli Lilly's blockbuster anti-psychotic drug

Zyprexa and restrict access to other prescription drugs.

At least 41 states, including Tennessee, have taken steps to create

preferred-drug lists, which encourage doctors to prescribe some drugs but not

others. Drug companies are not happy about that, and advocacy groups fear

vulnerable Medicare enrollees won't get the medications they need.

Of the 10 drugs that TennCare spent the most money on in the last half of 2003,

three of those - Zyprexa, Wyeth's Protonix and Tap Pharmaceutical's Prevacid -

would not be purchased under Bredesen's proposal to control costs.

The stakes are high for drug companies such as Lilly. Sales of Zyprexa reached

$4.3 billion last year, according to press reports, and accounted for one-third

of Lilly's sales.

TennCare paid $33.3 million for 111,370 Zyprexa prescriptions in the last half

of 2003. TennCare paid more for Zyprexa than for any other drug.

Bredesen wants TennCare to stop paying $5.47 for each dose of Zyprexa and

instead buy an alternative treatment that costs 33 cents per dose.

Lilly also faces problems in Texas, where the state removed Zyprexa from its

preferred-drug list for its Medicaid program.

''We don't agree with restricted access,'' said Anne , spokeswoman for

Lilly.

But the drug companies are not visibly opposing Bredesen. said last week

that it is a coincidence that Lilly and other drug companies gave $60,000 to a

coalition of mental health groups planning to lobby the legislature against

Bredesen's proposal during a ''day on the Hill'' at the state Capitol on March

16. The drug companies' funding accounts for 80% of the budget of the Tennessee

Coalition of Mental Health and Substance Abuse Services, said Anita Bertrand,

executive director of the Mental Health Association of Tennessee.

The coalition, which opposes any restrictions on the availability of

prescription drugs, realizes Bredesen might criticize it for taking money from

the drug companies, Bertrand said.

''What are we going to say to them, 'We're not going to take your money because

the governor is going to be upset?' '' she asked. ''We're not backing down.''

The coalition of about 20 advocacy groups is fighting Bredesen's plan to limit

the number of prescriptions TennCare enrollees can fill each month, to require

use of generic drugs instead of name-brand drugs, and to stop buying

prescription allergy and gastric acid remedies altogether.

When he outlined his plan for lawmakers last month, Bredesen warned them to

expect ''so-called grass-roots efforts'' to derail his proposal.

, though, said the coalition's ''day on the Hill'' had been planned since

last year, long before Bredesen's speech last month.

''Obviously this is not a reaction to Bredesen's recent proposal. I think the

timing just worked out that it's following his announcement. I don't think we

could have predicted what his proposal was going to be. If so, that's news to

me,'' she said.

In addition to Lilly, three pharmaceutical companies that gave money to the

mental health coalition that opposes Bredesen also manufacture some of the drugs

that TennCare spends the most money on.

AstraZeneca makes the schizophrenia drug Seroquel, which cost TennCare $16.4

million in the last half of 2003. Janssen makes Risperdal. TennCare paid $13

million for that drug between June and November 2003. Pfizer makes Zoloft, an

anti-depression drug that TennCare spent almost $13 million on over six months

in 2003. All three companies support the coalition, Bertrand said.

The pharmaceutical company Wyeth has two drugs on the top 10 list. In addition

to Protonix, the gastric acid drug that Bredesen said TennCare should no longer

buy, Wyeth makes Effexor, which treats depression and anxiety.

Wyeth is not reacting publicly to Bredesen's plan to crack down on TennCare's

drug costs.

''We're not going to be able to comment on this situation,'' Wyeth spokesman

Doug Petkus said.

TennCare's pharmacy costs are expected to be more than $2.3 billion this year,

which is more than the state spends on higher education. Bredesen said all of

the changes he wants to make would save $2.5 billion over four years.

If its spending is not controlled, TennCare will absorb nearly every dollar in

new revenue the state collects between now and 2008, leaving little money for

other priorities. That conclusion was reached by McKinsey & Co., the consulting

company commissioned to take an independent look at the program.

TennCare's total cost today is $6.9 billion. The state's share is $2.1 billion.

The federal government finances the rest. By 2008, the program's total costs

could be $12.2 billion with the state's share rising to $3.8 billion, the

McKinsey report concluded.

In addition to limiting each enrollee's prescriptions to six a month, Bredesen

wants to limit doctor visits to 10 a year and require co-payments.

Those limits would affect about one-third of TennCare's 1.3 million enrollees,

whom Bredesen described as ''able bodied.'' They would not apply to 859,000

pregnant women, children or disabled people, including some individuals with

mental illness or HIV/AIDS.

Everyone, though, would be expected to use the lowest-cost prescription drugs,

although some patients with mental illness would be allowed to continue with

their current drug therapies.

Using generics instead of name-brand drugs can result in big savings. BlueCross

BlueShield of Tennessee, the Chattanooga-based nonprofit insurance company,

increased the use of generics 1.3% last year and saved $5.3 million, spokesman

Bill Steverson said. Savings were also passed on to policy holders.

''$5 million is definitely nothing to sneeze at,'' he said.

A pharmacy advisory board is in the process of writing Tennessee's

preferred-drug list. Cost is not the only reason a drug would be included on the

list, TennCare spokeswoman Marilyn Elam said. Medications on the preferred-drug

list have to be as effective as those that are taken off.

''Equally effective is the first standard,'' she said. ''If it's cheaper but

doesn't work as effectively, that's not the answer.''

Advocates for patients who rely on mental health services aren't convinced that

drugs that wind up on a preferred-drug list are as effective as those that

don't.

''We've been fighting these battles in many states,'' said Bright,

spokeswoman for the National Mental Health Association.

The association receives funding from the pharmaceutical industry, the federal

government and private foundations, she said.

The source of funding does not affect the association's disturbing conclusions,

Bright said. ''No state is looking at how this affects patient health.''

Bredesen thinks he can control costs and protect patients at the same time. The

public battle that decides whether he gets the chance begins March 16, when the

mental health advocates get their day on the Hill, with the help of the drug

companies.

© Copyright 2002 The Tennessean

A Gannett Co. Inc. newspaper Use of this site signifies that you agree to

our terms of service (updated: 08/01/2001).

Associated Press content is Copyrighted by The Associated Press.

Jim - Norman

" Never look at the trombones, it only encourages them. "

Strauss