State Officials Consider Implications of Antipsychotics Study on Medi-Cal Spending
State health officials are examining a study on the efficacy of antipsychotic medications published last month in the New England Journal of Medicine and considering its implications for Medi-Cal drug spending, the San Francisco Chronicle reports. Four of the 10 drugs Medi-Cal spent the most money on in the past year are no more effective than cheaper, older generic alternatives, according to the study.
The study focused on the advantages and disadvantages of new, higher-cost brand-name schizophrenia drugs, four of the most expensive Medi-Cal drugs. Eli Lilly's Zyprexa, AstraZeneca's Risperdal and Seroquel and Bristol-Myers Squibb's Abilify were compared with the generic perphenazine.
Funded by the National Institute of Mental Health, the study followed 1,493 patients with schizophrenia throughout an 18-month national trial. The drugs were evaluated by determining their effectiveness in treating psychotic symptoms, the severity of side effects and the percentage of people who stopped taking them.
The Chronicle reports that the "cost differences between generics and brand-name antipsychotics ... are clearly significant" but adds that experts have not recommended that Medi-Cal switch to generics.
Robert Rosenheck, main author of the study and psychiatry professor at Yale University School of Medicine, said, "The paper showed very little difference between older drugs and [the new brand-name drugs]. But it's not for us, as researchers, to say what the policy decisions should be."
Kevin Gorospe, head of Medi-Cal's pharmacy policy unit, said, "We're interested in it, and we fully plan to have discussions with the authors to get more insight."
California health officials plan to examine the report closer and are waiting for the results of a follow-up study on the cost-effectiveness of the medications to be released (Colliver, San Francisco Chronicle, 10/23).
The complete study is available online.