The matrix red pill or blue pill2/17/2024 Thus, although the two treatments were deemed equally effective on average, it turned out that not reimbursing the newer more expensive drugs would lead to a loss valued at about a tenth of spending in this drug class. However, for those patients who would have responded better on a non-reimbursed treatment, there would be a loss of health and increased spending. Others would quit the drug but relapse, resulting in new hospital visits. Based on the CATIE trial, about a third of perphenazine patients would stay on the drug long term. If policymakers set out to simply substitute perphenazine for the three newer drugs in the Medicaid program, poor patients couldn’t afford to switch to a newer medicine. three newer drugs would really improve health and lower costs. In a recent study with Anirban Basu, however, I tested whether a policy in favor of generic perphenazine vs. This lead to widespread calls to reduce the use of the newer medicines, and about 40% of states did so through policies that discouraged doctors from such use. One of the heavily publicized findings from the report was that the newer medicines didn’t seem to be any more effective than the older, cheaper, generic ones. In 1999, the National Institute of Mental Health funded a $42.6 million study called Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) comparing the effectiveness of one first generation antipsychotic (perphenazine) with all of the atypicals currently available in the U.S. Costs for these drugs, however, have as a consequence gone up. As a result, the atypicals quickly dominated the market, accounting for 90% of prescriptions. This serious side effect can stigmatize patients, leading them to stop taking effective medicines.īy the 1990s, drug companies had developed a new class of drugs called atypical antipsychotics that had fewer side effects, including TD. These drugs were effective, but after prolonged exposure many patients developed a side effect called tardive dyskinesia (TD)–jerky, involuntary facial or limb movements that could become severe and permanent. In the 1950s, researchers created a class of drugs called “typical” antipsychotics, which were one of the first treatments for schizophrenia. Take antipsychotics, one of the biggest drug classes in Medicaid. Yet such “one-size-fits all medicine” will likely increase under centralized CER. The same meds that work well for some patients may not work for others indeed they may make others worse. Some cheaper medicines may become first-line treatments, even if they offer worse outcomes for many patients.īefore we deny patients access to expensive new medical innovations, we need to understand CER’s limitations and learn how to overcome them. Fiscal pressures mean that sooner or later CER will drive reimbursement decisions for public programs like Medicare and Medicaid. CER is a good idea but can be harmful when done through centralized methods.
0 Comments
Leave a Reply.AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |