Mentally ill concerned about drugs targeted by governor
NASHVILLE (AP) — Mental health advocates, always a presence at the Capitol, are particularly anxious this year, concerned about proposed limits on anti-psychotic drugs.
Many are worried that Gov. Phil Bredesen’s proposed TennCare overhaul will force them to stop taking drugs that keep them stable, contributing members of society.
Bredesen is considering the creation of a preferred drug list for psychiatric disorders similar to the limits on prescription options for other TennCare enrollees.
During his speech last month outlining proposed changes to TennCare, he zeroed in on the anti-psychotic drug Zyprexa as a driver in the out-of-control costs of the $7.8 billion program for 1.3 million poor, uninsured and uninsurable Tennesseans.
Tennessee taxpayers currently shell out more for Zyprexa than any other TennCare drug: $24 million a year.
Bredesen pointed to a recent study finding that Haldol, combined with a drug to combat its side effects, was as effective as Zyprexa in treating schizophrenia and costs much less.
However, mental health advocates who had their “day on the Hill” last week question whether the study was accurate and say some of the older anti-psychotic drugs such as Haldol cause such horrible side effects that some patients won’t take them and could wind up in jail, in the hospital or worse.
Sheryl McCormick of Knoxville says a friend told her that if he had to quit taking Zyprexa and use Haldol instead, “I would be a zombie again. If I had to go back to that, I would kill myself.”
The Bredesen administration doesn’t intend to take people off such drugs that are working for them, according to Gina Betts, his mental health commissioner. However, they might be not be a first option for new patients.
“We understand the anxiety,” Betts said. “But we are working through this deliberately and scientifically.”
She is seeking the suggestions of mental health advocates such as McCormick, who sits on the pharmacy committee of one of the governor’s TennCare working groups.
“I applaud the governor for what he is doing. I’m so glad he wants to save TennCare and not undo it and go back to Medicaid,” said McCormick, a co-founder of the Tennessee Coalition for Mental Health and Substance Abuse Services.
But she thinks he could find a better way to manage pharmacy costs. She suggests better monitoring of doctors, saying 80 percent of the atypical anti-psychotic drugs like Zyprexa are prescribed by primary care physicians and not psychiatrists.
“Each brain is so unique. We really don’t know which medications will work for a person until we try them,” said McCormick, who has suffered from bipolar and anxiety disorders since age 12 and found the right drug combination through trial and error.
The governor says the state should be “at the table” helping make such decisions, “not simply sitting there as a payer, so if a psychiatrist decides somebody needs something, that’s the end of the question and you should pay 15 times as much as competing drugs.”
There are also concerns that the mental health advocates are getting their information — and a lot of their money — from the pharmaceutical companies that stand to lose heavily if their drugs are taken off that table.
Eli Lilly & Co., which makes Zyprexa, and other pharmaceutical companies gave about $60,000 to the Tennessee Coalition of Mental Health and Substance Abuse Services this year.
But the coalition has received similar grants from the drug companies since 1995, according to Anita Bertrand, executive director of the Mental Health Association of Tennessee. She said the companies have no say in how the money is spent.
Eli Lilly spokeswoman Anne Griffin said the company asks advocates to reveal the donations. “We think transparency is important,” she said. Griffin said the companies are not using mental health advocates to combat the governor’s proposal.
“We wholeheartedly believe the governor wants to do the right thing for the people of Tennessee. And we want to work with him,” she said.
McCormick said she was offended at the idea that the drug companies were exerting undue influence over mental health advocates.
“If somebody can help us achieve our goals and it’s not compromising our principles, and this is in no way compromising them, why shouldn’t we take the money,” she said.