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. Kevin Kiermaier: Return to action Thursday 'didn't set the world on fire'

    The Heater

    Rays center fielder Kevin Kiermaier's return from the hip injury that sidelined him since June 8 could have gone better Thursday in Port Charlotte. He broke two bats and went hitless in two at bats while playing for the Class A Charlotte Stone Crabs.

    Kevin Kiermaier takes cuts in the cage during batting practice before the game between the Rays and Texas Rangers Saturday at Tropicana Field. [WILL VRAGOVIC   |   Times]
  2. U.S. economy gathers steam in second quarter


    WASHINGTON — The U.S. economy revved up this spring after a weak start to the year, fueled by strong consumer spending. But the growth spurt still fell short of the optimistic goals President Donald Trump hopes to achieve through tax cuts and regulatory relief.

    A government report released Friday showed economic output picked up in the second quarter. 
[Associated Press file photo]
  3. What you need to know about Bucs training camp


    Bucs training camp is here.

    This morning was the first of 13 practices that are free and open to the general public, so we have all the details to answer your questions about where and when and so on.

    Dirk Koetter is nothing if not precise, with practices starting at 8:45 a.m. and running until 10:27. [LOREN ELLIOTT | Times]
  4. Fennelly: It's high time for Bucs to take Tampa Bay back


    TAMPA — Welcome to the proving ground.

    Bucs training camp begins today.

    Hard Knocks and flop sweat.

    Work and more work.

    "We have a lot to prove,'' wide receiver Mike Evans (13) says. "We're good on paper, but we've got to do it." [LOREN ELLIOTT | Times]
  5. Old dog's lucky day: Video shows firefighters rescuing 12-year-old Shar-Pei mix from bay


    MIAMI BEACH — Junior spent Thursday night lounging on a pillow, too tired to move.

    Jose Ruiz takes a selfie with his dog named Junior after Junior was rescued from Biscayne Bay. [Photo courtesy of Jose Ruiz via Miami Herald]