FW: Massachusetts Medicaid clamping down on multiple prescriptions

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State seeks psychiatric drug cuts

Medicaid cites cost of multiple regimen plans

By Liz Kowalczyk, Globe Staff, 7/12/2002

Massachusetts, grappling with soaring Medicaid prescription drug costs, will

warn doctors about a practice officials say costs millions and may harm some

patients: physicians prescribing multiple psychiatric drugs - sometimes as

many

as seven - to individual patients.

Medicaid officials, who are seeking new ways to control drug spending,

recently

turned their attention to psychiatric medications, which gobble up half the

state's $890 million drug budget. They said they were surprised by what they

discovered: Nearly 5,000 patients on two or more antidepressants. More than

1,100 on five, six or seven different psychiatric medications. And even one

mentally ill man for whom doctors simultaneously prescribed 15 mood

stabilizers, antipsychotics, and anti-anxiety drugs.

Dr. Annette Hanson, the state's Medicaid medical director, said that

sometimes

psychiatric patients are so ill with numerous overlapping problems that

their

treatment requires some sort of drug cocktail, just as for AIDS patients.

But

she said that for various reasons, including the movement toward shorter

hospital stays, ''poly-prescribing'' or ''poly-pharmacy'' has gotten out of

hand.