The move comes amid growing scrutiny. The taxpayer bill for these meds jumped from $9 million seven years ago to nearly $30 million in 2006. Florida Medicaid records reportedly show the number of children - some just months old - who were prescribed the drugs went from 9,364 seven years ago to 18,137 in 2006. And even as drugmakers were being told to issue warnings about risks, a Florida Legislature-directed program partly funded by drugmakers was recommending the meds as treatment for ADHD, although FDA approval is lacking.
As a result, the Florida attorney general is considering whether to file a lawsuit. Now, the state's Agency for Health Care Administration is responding to concerns that the meds are being used inappropriately for treating ADHD, in particular, and will review coverage. The AHCA's own guidelines, by the way, state that "antipsychotics should not be used primarily to target ADHD symptoms, should not be used to promote weight gain, and should not be used as sedatives for children…and the use of antipsychotics in children under the age of six is generally not recommended."
Yet, a recent report by the University of South Florida found the most common diagnosis for antipsychotic treatment for youngsters in Florida's Medicaid program between July and December 2005 was for ADHD -and 54 percent involved children 5 years of age and younger, while 49 percent involved kids between ages 6 and 12 (please see table 5). And so nearly 40 percent of all antipsychotic scrips for youngsters were written for ADHD during that same period.
"We recognize that it may be necessary to review our long-standing guidelines in order to keep pace with evolving pharmacy science. AHCA secretary (Andrew) Agwunobi has requested the creation of a workgroup, under the Medical Care Advisory Committee, that will bring together experts in the field to determine if changes to our current policies are appropriate," an AHCA spokesman writes Pharmalot. "The group's findings will be presented to the Pharmaceutical and Therapeutic (P&T) Committee at their next meeting for their review and recommendations."