States seek Lilly help with Zyprexa costs

Concerned about the large and growing cost of antipsychotic drug Zyprexa, a number of states have taken Eli Lilly up on its offer to make sure Medicaid physicians stick to Zyprexa prescribing guidelines. The question, though, is whether states are getting what they're supposed to from these programs.

Zyprexa, which treats bipolar disorder and schizophrenia, generates the biggest single drug cost for state Medicaid programs. These programs spent $1.3 billion on the drug in 2005, accounting for nearly 25 percent of the drug's $4.2 billion in 2005 sales. Hoping to rein in its use, twenty states have taken Lilly up on its offer to monitor prescribing patterns. States that take Lilly up on its offer must agree not to require prior authorization for use of the drug, however. In addition, some states, such as Tennessee, have publicly questioned whether it was appropriate to let Lilly offer the program as a substitute for giving the state a drug discount.

Also, some state administrators have disputed that the consulting company that runs the program for Lilly, Comprehensive NeuroScience of White Plains, N.Y., is willing to consider cost-saving ideas that directly cut spending on Zyprexa prescriptions. Meanwhile, Lilly remains under state and federal investigation for its marketing of Zyprexa, as well as being the subject of lawsuits from seven states questioning its marketing tactics and willingness to disclose side effects.

To learn more about the Zyprexa monitoring program:
- read this piece from The New York Times (reg. req.)

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