for eMaxHealthA program sponsored by Eli Lilly has helped Medicaid programs in Minnesota and other states monitor prescriptions for psychiatric medications, the St. Paul Pioneer Pressreports. According to Minnesota officials, the program has helped thestate reduce costs and prevent unnecessary prescriptions forpsychiatric medications, but critics have raised concerns because thecompany has a financial interest in state policies that promote salesof such treatments (Olson, St. Paul Pioneer Press, 8/20).
Under the program, which Lilly launched in 2003, the company pays Comprehensive NeuroSciencean undisclosed amount to help state Medicaid programs monitorprescriptions for psychiatric medications. In the event that physiciansoverprescribe psychiatric medications to Medicaid beneficiaries, CNSsends "Dear Doctor" letters to inform them of the issue. Physicians donot have to comply with the letters. CNS also notifies physicians whenMedicaid beneficiaries do not renew their prescriptions for psychiatricmedications (Kaiser Daily Health Policy Report, 3/23).
Lillydoes not charge states that participate in the program. However,critics have raised concerns that "states are paying Lilly back forthis help by keeping its drugs off prior authorization lists," whichinclude medications that physicians cannot prescribe to Medicaidbeneficiaries without permission from the state, the Pioneer Press reports. None of the states that participate in the program has prior authorization lists for psychiatric medications (St. Paul Pioneer Press,8/20). Lilly manufactures Zyprexa, a treatment for schizophrenia andbipolar disorder that accounts for the single largest medicationexpenditure for state Medicaid programs (Kaiser Daily Health Policy Report, 3/23).
Lilly Response
Lilly spokesperson Janice Chavers acknowledged that the company seeksto discourage the use of prior authorization lists. She said, "We justfeel the doctor should be in the driver's seat as far as picking thebest medication, especially an antipsychotic" (St. Paul Pioneer Press, 8/20).
Reprinted with permission from kaisernetwork.org. Youcan view the entire Kaiser DailyHealth Policy Report, search the archives, and sign up for email deliveryat kaisernetwork.org/email. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, afree service of The Henry J. Kaiser Family Foundation.
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