Seroquel Slap-down

According to the Associated Press, via the Fort Wayne Journal Gazette, drugmaker AstraZeneca will have to pay 520 million in fines to resolve “allegations of illegal marketing of the company’s antipsychotic drug Seroquel.”

“AstraZeneca allegedly marketed Seroquel for off-label uses — those not approved by federal drug regulators — including insomnia and psychiatric conditions other than schizophrenia and bipolar disorder.”

In addition,

“U.S. Attorney Michael Levy of Philadelphia, where the settlement was filed, said that the company had “turned patients into guinea pigs in an unsupervised drug test.”

AstraZeneca, which has its U.S. headquarters in Wilmington, Delaware, faces more than 25,000 product liability lawsuits over Seroquel, with most alleging that the drug caused diabetes. Seroquel has been on the market since 1997.

The government said AstraZeneca paid kickbacks to doctors recruited to serve as authors of articles by Astra Zeneca and the company’s agents about the unapproved uses of Seroquel.

The company also made payments to doctors to travel to resort locations to advise AstraZeneca about marketing messages for unapproved uses of the drug, the government stated.

AstraZeneca denied the allegations leveled by the government in the civil case settled Tuesday, saying it wanted to avoid the delay, uncertainty and expense of a protracted legal battle.”

The story goes on to state the drug is the second best seller for the company, generating sales of 4.9 Billion dollars.

PLA Changes Notice Procedures

The Blogmeister was recently made aware the Indiana Professional Licensing Agency (PLA) was notifying current licensees of the need to renew their licenses via email.  While the PLA is to be congratulated for attempting to save money on postage (they used to mail the reminders), they apparently did not realize many people change email addresses over the two year license period.   End result…  some people did not receive the notice and their licenses expired.  As of the time of this post, they are allowing people to still renew their licenses, but there is an additional fifty dollar fee.  Some people are reporting they received a mailed notice of this policy change, while others are being caught unaware.  The Blogmeister’s advice?  Check your license status ASAP and renew if you are expired.

Spring presents at IAMFT Spring Conference

Janis Abrams Spring presented last Friday (April 23, 2010) at the IAMFT spring conference on the topic of forgiveness.  Spring, who is the author of “After the Affiair” and “How can I forgive you” presented her methods for helping patients work through forgiveness issues regardless of the perceived hurt.  Spring was an excellent speaker who gave a clear and concise lecture of her methods, lacing the talk with plenty of examples.  She also took many questions from the audience of about 120 participants, which included Psychologists, Marriage and Family Therapists, Social Workers, and Mental Health Counselors.

IAMFT Welcomes AAMFT Prez

The Indiana Association of Marriage and Family Therapists welcomed Linda Schwallie, president of the American Association of Marriage and Family Therapists to their spring conference last friday (April 23, 2010).   President Schwallie gave a brief address following lunch detailing the state of the association and the strategic planning process currently underway within the association.  I had the opportunity to talk with her briefly when I arrived (late!) for the conference.  I was impressed with her passion for the association and profession and her willingness to discuss and listen to any topic.

IST Gets Ranked as a “Top Pharmacy” Blog

The Blogmeister firmly believes in the old adage that says something to the effect of “you have to say good things about yourself, because no one else will.” So, in that vain (pun intended)…

We are happy to report nursingdegreeguide.org writer Joel West has ranked INdiana Systemic Thinking as number 33 on his top pharmacist blogs. He writes:

33. Indiana Systematic Thinking: Posts related to mental health pharmacology, as well as other pharmacology-related posts are available through Indiana Systematic Thinking.

While we don’t feel our primary focus is pharmacology related posts, it does appear we do our fair share of it. Thanks so much to nursingdegreeguide.org and Joel…we appreciate it!

Complicated Grief Just Got More Complicated

Newsweek’s online edition carried an interesting story recently on new research focusing on complicated grief.  According to Newsweek:

In a paper in the journal Neuroimage, O’Connor and her colleagues describe using an fMRI machine to probe the neurological basis for complicated grief among a small sample of women who had lost a close relative to breast cancer. Ordinary grief is apparent on a brain scan: show a bereaved daughter a picture of her mother, and areas of the brain that process emotional pain are activated. The women with complicated grief showed that pattern, but something else as well: activity in the nucleus accumbens, a brain region associated with pleasure, rewards and addiction. “When the women came out of the scanner, the complicated-grief group rated themselves as feeling more negative than the others,” O’Connor said. “But they also said things like, ‘Oh, it was so nice to see my mom again.’ These are the ones who pore over picture albums, talk about the person all the time, almost as if she was still here.” The women in that situation were unconsciously prolonging their grief, she concluded, because memories of the person they missed gave them pleasure—as well as pain.

Interesting, but it causes one to wonder…  As practicing clinicians what are we to do to treat these patients?  Do we encourage them not to look at pictures, etc, or do we encourage it.  Perhaps further studies will give us some direction, but the basic research provided here gives a good explaination of what is going on with these grief stricken individuals.

GlaxoSmithKline Pays out big on Paxil… …Again!

The Wall Street Journal’s Health Blog is reporting GlaxoSmithKline is paying out another 40 million in ongoing litigation regarding the antidepressant, Paxil.

GlaxoSmithKline is shelling out another $40 million to deal with the fallout over the use of its antidepressant Paxil in kids. This time, the money is going to insurers who paid for the drug to be used in children and adolescents.

A class-action lawsuit argued that Glaxo had promoted the drug for use in children, while withholding evidence that the drug was neither safe nor effective in kids. Glaxo denied those charges and told the WSJ it settled to “avoid the costs, burdens and uncertainties of ongoing litigation.”

Mental Health Parity Passes as part of Bailout Bill

As I reported here early Friday morning, Mental Health Parity was attached to the bailout bill passed by the Senate last Wednesday.  It went to the House of Representatives on Friday, and was passed.  I recieved a confirmation of this yesterday from the American Association of Marriage and Family Therapists, which I would like to post, but my email server is currently down, so I can’t paste it into this post.  However, CNN has a story here that explains, as well as confirms passage.

All I can say is it’s about damn time, and to all those who worked tirelessly for this cause, I applaud and thank-you.  Sometimes we get all wrapped up in how “pork” should be left out of bills, but in this case, parity is something that should have happened a long time ago and everyone will benefit.

Big Insurance and “The Sentinal Effect”

Dr. Benjamin Brewer had a great article on the Wall Street Journal site about insurance companies requiring preauthorization for medications and services.  Most people don’t know, as mental health professionals, we almost always face the same unjust scrutiny by big insurance.  As this quote points out, insurance companies, in an effort to save money, hope that by making the preauthorization process as difficult as possible, we will all just give up, saving them money.

“They want me to incur the overhead and frustration that comes with trying to prove to a non-doctor that I know my patient and what I’m talking about. They want to cut costs, and they don’t really care about how it affects my patients or my practice. If they make the process hard enough, they hope I’ll just give up. There is even a term in the managed care literature for that kind of deterrence: the “sentinel effect.”

Just so you don’t have to click over, the Sentinal effect:

deters utilization by requiring the administrative effort necessary to authorize the procedure. “Studies have shown the sentinel effect to be persuasive

This “administrative effort” transfers over to big money, in my practice at least a third.  Of course this is passed on to our patients, but not the one’s who have insurance, as the insurance companies won’t pay us for the time it takes to cut through their red tape.  Instead, we have to charge higher rates, and pass the costs on to our private pay clients.

Just another example of how Big Insurance IS the problem in healthcare…  Not the answer.

The Bailout AND Mental Health Parity???

Wow, this was a shocker when it came across the news feed. Apparently Senate proponents of mental health parity had only one legislative vehicle left to carry their bill this year…the mortgage industry bailout bill! What is mental health parity you ask??? Well, according to the Associated Press:

“Currently, insurance plans routinely require mental health patients to pick up more of the initial costs of their care through higher deductibles and co-payments. Other times, insurance plans have stricter limits on how often patients with mental problems can see their doctors.”

Specifically, the bill would make coverage the same whether the patient had a mental or physical problem and…

“…apply to health plans that cover more than 50 employees – potentially reaching 113 million people nationwide.”

Parity is a good idea for many reasons. First, a more mentally healthy workforce is a better workforce. Second, it will help put mental health care on a par with physical health care and reduce some of the stigma still prevelant in the population. Still, it had it’s detractors. Anyone know who??? Of course, our friends at big insurance who successfully lobbied so the

legislation does not mandate that group health plans cover mental health or addiction treatment. But if they do, the coverage must be equitable with other medical coverage.

Now, according to the AP, they (insurance companies) support the legislation.

For those not following all this drama, the legislation has been negotiated and renegotiated for almost seven years. It even came up for a vote a time or two. Now that all sides agree, it should pass, but the authors lacked a way to get it in front of the entire Senate. So, in a common strategic move, they have tacked it on to the mortgage bailout bill, which passed the Senate on Wednesday, and is up for a House vote today. So, despite how one may feel about the current mortgage mess, if you are a supporter of parity, you may want to support the bailout bill and encourage your Representative to as well.

Post updated here.