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Psychiatrists perceived Medicaid drug restrictions as barriers
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Medicaid restrictions in many states, such as prior authorization, fail-first or step therapy, formulary restrictions or quantity limits, affect the perceptions of psychiatrists, according to recent study data.
“Our research shows that many obstacles continue to limit mental health providers’ ability to effectively provide care,” researcher Ruth S. Shim, MD, MPH, department of psychiatry at Lenox Hill Hospital, New York, said in a press release. “The next step is to take policy action to remove these barriers to increase access to and quality of care for individuals living with mental illnesses.”
Between June and August 2013, email questionnaires were sent to psychiatrists affiliated with the National Council for Behavioral Health requesting participation in an online survey conducted by the council and the National Alliance on Mental Illness. Of the 435 surveys returned, 55% met inclusion criteria.
Formulary restrictions were cited as “always” or “often” perceived as barriers by 55% of respondents, and prior authorization by 55%. Fail-first or step therapy were cited as “always” or “often” barriers by 50% of respondents. More than one-third of respondents reported spending 11% to 20% of their time on tasks related to prior authorization.
Being able to select from multiple psychiatric medications was important to 66% of respondents, and 61% said they may need to try multiple medications to determine which is most effective for a patient. Various levels of tolerability of different medications was reported by 64% of respondents.
“Mental health treatments are not one size fits all,” Linda Rosenberg, MSW, president and CEO of the National Council for Behavioral Health, said in the release. “Choosing the right plan should be the decision of a patient and their doctor, not rigid health plan policies. Increasing options, reducing paperwork and restoring physician authority ultimately results in better patient care.”
Disclosure: The study was funded by a grant from Sunovion, Takeda Pharmaceuticals, and Lundbeck. The researchers report no relevant financial disclosures.