Proposal would protect access to antipsychotic medication for low-income Missourians

April 02-- Apr. 2--JEFFERSON CITY -- Current state laws prohibit MO HealthNet, which provides health insurance to poor Missourians, from restricting access to antipsychotic drugs. But a closer look at the statute could allow different interpretations, according to a Missouri lawmaker and mental health advocates.

Gena Terlizzi, executive director of the Missouri office of the National Alliance on Mental Illness first realized the potential leniency of the law last summer when the Missouri Drug Prior Authorization Committee attempted to limit access to certain brands of antipsychotic medication through a preferred drug list.

Agency documents show the state was attempting to save a few million dollars from the overall $10 billion MO HealthNet program.

"We were very appreciative they decided not to move forward with that plan, but it also opened our eyes to the fact that some of the language in the bill could be interpreted or misinterpreted," Terlizzi said.

On Monday, Rep. David Gregory, R-St. Louis County, brought forward a proposal he says would "ensure the continued access to the full spectrum of antipsychotic drugs."

"Right now I believe the current statute's intent was to protect access to antipsychotic drugs" Gregory told the Health and Mental Health Policy Committee. "But if you take a closer look at the statute, it could be ... construed differently than its being construed now so what this bill seeks to do is clean that up and make sure that we continue operating in the same way that we have been operating."

Antipsychotic medications have consistently been among the most expensive drugs paid for by the state.

Although Gregory's proposal would not subject the state to increased expenses, Rep. Steve Helms, R-Springfield, asked how the state could otherwise counteract the rising cost of medications.

Terlizzi mentioned a new initiative from MO HealthNet that offers providers a reference list breaking down the more and less expensive medication options. Although prices might sway prescriptions preferences, Terlizzi says providers are not bound to a specific option as they would be with a restricted list.

Several proponents reinforced the idea that restricting access to medication is not the way to save the state money. Missouri Psychiatric Physicians Association President Sherifa Iqbal explained that states often face greater costs through prison and mental health facility bills when individuals with severe mental illnesses do not receive proper medication.

Iqbal added that individuals lacking access to proper prescriptions suffer potentially permanent consequences.

"Mounting research shows severe and persistent mental illness changes the brain. Any delays in care increases the risk of damage and therefore, time is brain," Iqbal said. "Any obstacles in obtaining appropriate, clinically indicated medications, cost the patient and their loved ones dearly, permanently and arguably unnecessarily."

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