Michigan Makes More Mental Health Drugs Available Without the Need for Prior Authorization

June 20, 2003

Michigan Department of Community Health Director, Janet Olszewski, today announced that the Pharmacy and Therapeutics Committee has made changes to the Michigan Pharmaceutical Product List to make more mental health drugs available without the need for prior authorization.  The list, also referred to as the Preferred Drug List, applies to persons with Medicaid insurance coverage or in other department-sponsored coverage programs.

“We have listened to the concerns of the mental health community and felt it was important to be responsive to the specialized needs of persons with mental illness,” said Olszewski.  “Maintaining the delicate balance of mental health treatment is a vital part of helping persons with mental illness have an improved quality of life.  Making more of these critical drugs available without the need for prior-authorization helps to avoid possible setbacks in care due to changes in drug treatment therapy.”

Selective Serotonin Reuptake Inhibitors (SSRIs) are new drugs for treatment of depression and some anxiety conditions.  They have largely replaced the older drugs used for this purpose in most patients because they are relatively safer in overdose and have more tolerable side effects.  SSRIs appear to be safer especially in patients with heart disease, and for patients on multiple medications who cannot tolerate some of the anticholinergic effects of the tricyclic antidepressants, or who would be more at risk of drug interactions with their other medications.  SSRIs available without the need for prior authorization include:  Celexa, Fluoxetine, Fluvoxamine Maleate, Lexapro, Luvox, Paroxetine, Prozac Weekly and Zoloft.

Atypical Antipsychotics are primarily used in treatment of schizophrenia and have allowed many chronic mentally ill patients to live in the community instead of institutions, to avoid some of the dangerous and permanent side effects of the drugs used previously to treat these conditions, and to help individuals unresponsive to previous treatment options.  Atypical Antipsychotics available without the need for prior authorization include:  Abilify, Clozapine, Geodon, Risperdal, Seroquel, Zyprexa, and Zyprexa Zydis.
The Department of Community Health spends over $1 billion annually providing pharmaceuticals for 1.4 million Medicaid and non-Medicaid beneficiaries.  The Michigan Pharmacy and Therapeutics Committee follows a clinically based process when reviewing and evaluating the Michigan Pharmaceutical Product List.  The list ensures that all Medicaid beneficiaries receive the same comprehensive pharmacy coverage available, while reducing the cost of pharmaceutical products to the state.  Physicians and patients continue to have access to all FDA approved drugs.