Colorado’s top Medicaid prescriber of drugs at the center of a U.S. senator’s probe into fraud, waste and abuse in the Medicaid system billed nearly $1.1 million in 2008 and 2009 for 1,304 prescriptions written on four expensive antipsychotic drugs, according to data obtained by the Citizens Commission on Human Rights of Colorado.
The high-prescribing doctor was identified only by the prescriber identifier number 1093800559 in data compiled by the Colorado Department of Health Care Policy & Financing (CDHCPF) in response to a request from U.S. Senator Charles Grassley of Iowa, ranking Republican on the Senate Finance Committee, which oversees Medicaid and Medicare.
In April the senator requested 2008 and 2009 data from all 50 state Medicaid agencies on the top 10 Medicaid prescribers for each of six antipsychotic and two narcotic drugs, citing his concern they are being overprescribed at great cost to the publicly-funded Medicaid and Medicare programs. Following his review of the data, Grassley called for a federal investigation.
Collectively Colorado’s top 10 Medicaid prescribers of the six antipsychotic drugs in question billed Medicaid a total of $8,172,649 over the two-year period, billing $3,045,015 in 2008 and $5,127,634 in 2009 for a 68 percent increase.
Colorado taxpayers have good reason to be concerned not only about the mushrooming cost of expensive antipsychotic drugs prescribed by Medicaid psychiatrists, but also the medical costs of the physical damage these drugs can cause to the Medicaid patients taking them.
The ages of the patients for whom the prescriptions were written were not part of the released data, so it is not known whether the huge jump in prescriptions in Colorado reflects the growing nationwide trend of putting children on antipsychotics, especially poor children. A Rutgers University study last year found that children from low-income families, like those on Medicaid, were four times as likely as the privately insured to be put on antipsychotic drugs.
Drug studies of newer antipsychotics have found they can cause serious side effects in children, including diabetes, obesity, elevated cholesterol, seizures and strokes.
According to a recent article in The New York Times, “a marketing juggernaut…has made antipsychotics the nation’s top-selling class of drugs by revenue, $14.6 billion last year, with prominent promotions aimed at children.”
Because none of Colorado’s top Medicaid antipsychotic prescribers is identified by name in the CDHCPF data, it is not possible to track any financial ties they might have with the pharmaceutical companies that make these drugs, which could lead to a higher use of the drugs and a higher cost to the Medicaid program without benefiting patients.
Recently enacted national health care reform will require pharmaceutical companies to disclose payments to doctors beginning in 2013. In the meantime Eli Lilly & Co. and Pfizer, makers of two of the antipsychotic drugs targeted by Sen. Grassley, must already disclose their payments to doctors as part of agreements reached with the U.S. Department of Justice.
With Colorado already facing what the governor’s office estimates as a $262 million general-fund shortfall for the current 2010-11 budget and facing another $1 billion shortfall in the 2011-12 budget year, details of the number and cost of prescriptions for antipsychotic and other psychiatric in the publicly-funded Medicaid program over the past 10 years should be made public, with a special focus on the increase in the number and cost of prescriptions written on antipsychotics for children.
If you or someone you know has been harmed by taking antipsychotic drugs and you want to talk about it, we want to talk to you. Email us or call 303-789-5225. All inquiries and communication will be handled in strictest confidence. We will take action.
