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Restrictive Prescription Drug Policies Hurt Schizophrenics
Date:4/1/2008

Harvard study found program made patients 29% more likely to stop, disrupt their meds

TUESDAY, April 1 (HealthDay News) -- Restrictive prescription drug policies can cause schizophrenia patients to stop taking their medications, a Harvard Medical School study suggests.

Researchers looked at Medicare beneficiaries with schizophrenia in Maine before, during and after a policy that required patients to use an authorized medication (step treatment) before they were permitted to be prescribed drugs not on the preferred list. They were compared to Medicare beneficiaries with schizophrenia in New Hampshire, where there was no such regulation.

The study found that the Maine patients were 29 percent more likely to stop or disrupt medication when subject to the tightened policy. In addition, the restrictive drug policy -- originally designed to reduce costs -- provided only minimal savings.

After less than one year, the Maine policy was replaced by a provider education program, noted the authors of the study, which was published online April 1 in the journal Health Affairs.

"This study calls into question the effectiveness of many similar policies throughout the country," study senior author Stephen Soumerai, a professor at Harvard Medical School, said in a prepared statement. "Getting prior authorization requires paperwork and is time-consuming, so physicians may tend to switch to prescribing preferred medications even if they have concerns about the appropriateness of the medication for a specific patient."

As their medication choices are restricted, more patients discontinue treatment, Soumerai noted.

Previous research has found that interruptions in taking antipsychotic medications are likely to lead to recurrence of psychotic episodes and higher hospitalization rates and costs for patients.

Schizophrenia affects 1 percent of the U.S. population, or about 3 million people. W
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