The American Psychiatric Association (APA) is pushing Congress to pass legislation it says would ensure access to psychotropics and other lifesaving medications for Medicare recipients.
Sens. Gordon Smith (R-Ore) and John Kerry (D-Mass) introduced the Medicare Access to Critical Medications Act July 26.
Guidelines issued by the Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS) call upon Medicare prescription drug plans (PDPs) to cover essential psychotropics, anticancer drugs, HIV/AIDS medications, and drugs needed to sustain organ transplants. Many PDPs have not followed these guidelines, leading to denials in coverage that in some cases have compromised outcomes, says APA President Carolyn Robinowitz.
If enacted, Dr. Robinowitz said, the bill would:
• codify protections that would require PDPs to include “all or substantially all” antipsychotics, antidepressants, and anticonvulsants on their formularies
• require a medication to be covered during an appeals process with a PDP
• require CMS to report the number of coverage determination appeals for these medications.
Language barriers affect use of psychiatric services and access to care more than ethnicity alone, new findings suggest.
Researchers at the University of California-San Diego School of Medicine studied use of San Diego County’s Adult Mental Health Services across 5 years among more than 6,000 Caucasians, English-speaking Latinos, and Spanish-speaking Latinos.
Compared with the other groups, Spanish-speaking Latinos:
• had the highest proportion of major depression and lowest proportion of bipolar disorder, schizophrenia, and substance use disorders
• had the highest proportion of patients receiving outpatient services but the lowest number of visits overall
• were most likely to live independently or with family members and least likely to be homeless or living in nursing homes
• were most likely to receive initial treatment for severe mental illness in outpatient facilities and least likely to receive initial care in the emergency room or jail.
Overall, Caucasians and English-speaking Latinos showed similar patterns of mental health service use.
“Disparate health care for racial and ethnic minorities is a major public health concern,” said National Institute of Mental Health Director Thomas Insel, MD, whose agency funded the research. “Studies such as this will help define these groups’ needs and improve care.”
The findings appear in the August American Journal of Psychiatry.
Researchers say they have found a genetic variation that might explain why some women are more susceptible than others to premenstrual dysphoric disorder (PMDD).
Researchers at the University of North Carolina-Chapel Hill School of Medicine studied 91 women diagnosed with PMDD at least 3 months before the study and 56 women with no history of mood disorders related to the menstrual cycle.
The team discovered four specific genetic variants in one of the two genes that encode the estrogen receptor. Women with PMDD were significantly more likely than control-group women to have the gene variants, the study found.
The results will appear in an upcoming issue of Biological Psychiatry.
The American Psychiatric Association (APA) has announced the task force that will oversee development of DSM-V, which is scheduled to replace DSM-IV-TR in 2012.
The task force includes:
• David J. Kupfer, MD (chair)
• Darrel A. Regier, MD, MPH (vice chair)
• William Narrow, MD, MPH
• Maritza Rubio-Stipec, ScD
• William T. Carpenter, Jr., MD
• Francisco Xavier Castellanos, MD
• Wilson M. Compton, MD, MPE
• Joel E. Dimsdale, MD
• Javier Escobar, MD, MSc
• Jan Fawcett, MD
• Steven E. Hyman, MD
• Dilip Jeste, MD,
• Helena C. Kraemer, PhD
• Daniel T. Mamah, MD, MPE
• James McNulty, AB, ScB
• Howard B. Moss, MD
• Charles O’Brien, MD, PhD
• Roger Peele, MD
• Katherine A. Phillips, MD
• Daniel Pine, MD
• Charles F. Reynolds III, MD
• Andrew E. Skodol II, MD
• Susan Swedo, MD
• B. Timothy Walsh, MD
• Philip Wang, MD
• William Womack, MD
• and Kimberly A. Yonkers, MD.
Roughly one-third of medical students have a low opinion of pharmaceutical companies, results of Epocrates' Future Physicians of America survey suggest.
Among more than 1,000 medical students who responded, only 17% said they have a positive opinion of the industry, and nearly half believe pharma sales representatives can influence prescribing.
Among other findings:
• Slightly more than half (56%) said sales representatives shape their opinion of the pharmaceutical industry.
• Nearly one-third fear direct-to-consumer advertising is undermining physicians' authority and expertise.
