Mental health advocates are calling a drug bill into question due to concerns over the potential negative effects that it will have on mental health patients. The bill was passed by Kansas lawmakers and will require doctors to try cheaper drugs before more expensive ones on Medicaid recipients.
The process is called step therapy and is nothing new within private and public health insurance plans. It was integral in solving numerous budget issues through its reduction of the cost of providing for health care for poor residents.
However, Rick Cagan, executive director of the Kansas affiliate of the National Alliance on Mental Illness, points out that everyone reacts differently to psychiatric drugs in terms of tolerance and response.
"Individuals and their prescribers need to have the greatest degree of flexibility to ensure a good match for patients," he said. "We don't know as much about how the brain responds to this whole kind of cadre of medications ... as we do with cardiac and other kinds of medications."
Nevertheless, the lawmakers who supported the bill, which is expected to be signed on Monday, believe that safeguards are in place to protect those with mental health problems and advocates are simply looking for an unfair exemption from a practice that numerous insured patients must face.
"They just want to be left totally outside so that they don't have to do anything like the rest of the world has to do," said Republican Sen. Jim Denning, of Overland Park. "If a new patient comes into the system, they will be given the right drug or combination of drugs to keep them as healthy and as well as we can."
Despite Denning's assertions, many think that the bill will lead to limitations in the access of certain medication due to cost. Furthermore, there are worries regarding the ability of mental health patients to understand the administrative hurdles that they need to overcome if they're turned away from their doctor due to drug pricing.
"For someone who doesn't own their own transportation, who may or may not have strong cognitive abilities ... our biggest fear is that they will walk out of the pharmacy and they don't come back for the adjustments to be made," said Amy Campbell, lobbyist for the Kansas Mental Health Coalition.
Medicaid currently costs Kansas $3 billion per year, and step therapy could save the state up to $11 million per year. Supporters believe that despite concerns, the process is used across the country and issues of mental health will be taken into consideration.
