[Jun 14, 2005]

      Mental health experts in Florida warn that the state's plan to reduce Medicaid spending on prescription drugs to treat mental illnesses by $292 million through limits on brand-name treatments could endanger the health of Florida's low-income, mentally ill residents, the Orlando Sentinel reports. Under the plan, which was approved by the state Legislature this spring, physicians will be required to prescribe the least-expensive treatment for a patient's condition first. More expensive treatments are authorized only if that treatment fails, according to the law. In addition, patients will be limited to four brand-name psychotropic drugs per month, as well as four generic medications. The changes are scheduled to take place July 1 after the number of medications on the state's prescription drug formulary is reduced by a panel of pharmacists and the state Agency for Health Care Administration. Stephanie Walker, a spokesperson for AHCA, said the changes will "control spending" on and "utilization" of mental health medications. However, patient advocates maintain the changes will result in more emergency department and emotional-crisis unit visits by mentally ill patients. Kathleen Hale, president of the National Mental Health Association, said, "[T]he inability to access particular psychotropic medications will result in serious destabilization, while for others it will mean a descent into psychosis." Psychiatrist Samuel Roura said officials have failed to realize that "people are different and that the medication needs to be tailored to the specific individual." He added, "This is legalizing malpractice for the Medicaid population. We'll be making a decision based on cost and not on sound medical judgment. It's putting the Medicaid population at risk" (Hollis, Orlando Sentinel, 6/13).

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