Make us your home page

Today’s top headlines delivered to you daily.

(View our Privacy Policy)

Lobbying mounts to get Florida approval of two costly schizophrenia drugs

When the public pays the bill, who decides whether a pricey new drug is worth the cost?

For Florida's Medicaid patients, those recommendations come from a panel of doctors and pharmacists who review medications to determine if they should be on the state's preferred drug list.

But a meeting today of the group has sparked warnings that if two expensive new treatments for schizophrenia are rejected, it could be devastating for the mentally ill.

Who's behind the warning? Janssen, maker of one of the new drugs under consideration. Janssen's Invega Sustenna is a monthly injection for schizophrenics that costs up to $2,000 per shot.

Lauren Tate, the New York City publicist running the campaign on behalf of Janssen, insisted that the drugmaker's involvement was irrelevant. But the lobbying effort provides a glimpse at the difficulty of controlling medical costs.

In Florida, Medicaid's pharmaceutical and therapeutics committee meets four times a year to review products' cost and efficacy compared with other medications in the same class. The goal: provide Medicaid patients access to drugs they need without busting the budget.

Anti-psychotics are of particular concern because they are among the most expensive drugs prescribed for chronic conditions. And though most anti-psychotics are approved for only the 2 percent of the population with schizophrenia and bipolar disorder, they are widely prescribed by doctors to treat conditions ranging from insomnia to ADHD.

The Medicaid committee will review both Janssen's Invega Sustenna and Saphris, a new dissolvable tablet for schizophrenia and bipolar disorder from Merck. Currently, the preferred drug list includes nearly all branded and generic anti-psychotics. Most injectable anti-psychotics, however, require prior approval so the state can monitor their usage.

Dr. Daniel Carlat, a psychiatrist and professor at Tufts University School of Medicine in Boston, said Invega Sustenna seems designed to replace a similar twice-monthly injectable from Janssen. That drug is losing patent protection, so a cheaper generic version will be out soon.

"And once it gets cheaper, I'd be hard pressed to put a patient on the more expensive drug," he said.

Carlat, a well-known critic of drug marketing, also said he hasn't seen any strong arguments for prescribing Merck's Saphris. "Maybe it has a place for those rare patients who have swallowing problems."

But Dr. John Bailey, a Tallahassee psychiatrist who is past president of the Florida Psychiatric Society, said mentally ill patients and their physicians should have easy access to all approved treatments. Though he has not prescribed either new drug, he said Janssen's monthly injection could be especially useful for severely ill patients who neglect to take daily medications.

"It's an expensive acquisition cost, but if the patient is noncompliant, that expense is just shifted to the ER or hospital when the patient ends up there," Bailey said. "Overall, the taxpayer still sees those costs."

Medicaid's pharmaceutical and therapeutics committee is scheduled to meet at 9 a.m. today at the Tampa airport Marriott. Public comment is limited to individuals who have preregistered.

Lobbying mounts to get Florida approval of two costly schizophrenia drugs 01/11/10 [Last modified: Tuesday, January 12, 2010 9:38pm]
Photo reprints | Article reprints

© 2017 Tampa Bay Times


Join the discussion: Click to view comments, add yours

  1. Joe Henderson: Other good works can't balance theft from vulnerable victims


    What price can you put on your good name?

    This renovated group home once was operated by HARC. The group's former CEO Richard Lilliston was credited with raising millions for the agency but has been sentenced to prison for stealing Social Security from clients with developmental disabilities. [Times file]
  2. Five reasons why Kentucky can beat Florida for the first time since 1986


    By Matt Baker

    GAINESVILLE — Florida's 30-game winning streak over Kentucky is one of the most impressive feats in the country.

    Florida Gators offensive lineman Martez Ivey (73) celebrates Florida Gators running back Mark Thompson's  (24) touch down in the first quarter, putting Florida on the board 6-0 during the game between the University of Florida and the University of Kentucky in Ben Hill Griffin Stadium on Saturday, Sept. 10, 2016, in Gainesville, Fla. Florida defeated Kentucky 45-7. ANDRES LEIVA   |   Times

  3. Once targeted by the Bucs, Dalvin Cook thrills for the Vikings


    How good would the Bucs be with running back Dalvin Cook?

    Minnesota Vikings running back Dalvin Cook (33) slips a tackle by Steelers strong safety Sean Davis (28) to score a touchdown Sunday in Pittsburgh. [AP photo]
  4. Review: More than 20 years later, 'RENT' still matters


    TAMPA — Two decades after Rent shook up Broadway with a starkly joyous musical that demanded to be recognized, a nostalgic tour is taking audiences back.

    The 20th anniversary tour of RENT, shown in 2016, comes to the David A. Straz Jr. Center for the Performing Arts Sept. 19-24, 2017. Photo by Carol Rosegg.
  5. Dennis Miller, headed to Tampa with Bill O'Reilly: 'We don't know each other that well'


    Dennis Miller often gets cast as the odd comic out these days.

    Dennis Miller will perform with Bill O'Reilly at the Spin Stops Here Tour at Amalie Arena in Tampa. [Spuffy Productions]