Managing psychotropic drugs can cut health tab

January 23, 2006

An aggressive program of psychotropic drug prescription management saved the Missouri Medicaid program $7.7 million in fiscal 2004. Named Behavioral Pharmacy Management (BPM), the program analyzed drug claims—including inpatient psychotropic prescriptions— to identify inappropriate prescribing patterns.

An aggressive program of psychotropic drug prescription management saved the Missouri Medicaid program $7.7 million in fiscal 2004. Named Behavioral Pharmacy Management (BPM), the program analyzed drug claims-including inpatient psychotropic prescriptions- to identify inappropriate prescribing patterns.

BPM was developed by Comprehensive NeuroScience (CNS) in White Plans, N.Y. Missouri is one of 26 states that have signed service contracts with CNS to use the retrospective program. It was the first state to implement the program and the first to complete and publicize an outcomes analysis, said John Byrd, R.Ph., CNS director of outcomes research and pharmacy services.

"The goal of BPM is to encourage physicians to prescribe psychotropic drugs appropriately, not to tell them how to practice medicine," said Byrd. "We offer analysis relative to scientifically determined best practices, not cost or formulary compliance."

MHMPP began in May 2003 with an evaluation of Medicaid prescribing records, examining utilization of 138 active ingredients found in a wide range of psychotropic drugs. The state then identified several doctors who were not following recommended psychotropic treatment guidelines.

The doctors were contacted by mail and were sent educational materials about best practices. They were encouraged to adjust their prescribing habits, but compliance is voluntary, said MHMPP officials. "All decisions regarding medications are made privately between the physician and the patient," said Parks.

The state began seeing changes in prescription patterns within 90 days. Analysis of first-year data found:

The results of a separate analysis of BMP by CNS were described at a joint American Psychiatric Association Institute on Psychiatric Services and Disease Management Association of America meeting in San Diego in October 2005. CNS reported on an analysis of the claims records of 1,911 Medicaid recipients whose physicians received notification of at least one of the program's quality indicators during two consecutive mailings.

Researchers found: