Antipsychotic drugmakers target marketing dollars at D.C. Medicaid psychiatrists, study indicates

Antipsychotics are one of the top-selling drug classes; In 2010, top antipsychotic manufacturers spent more than $25 million on marketing in Washington DC. Among 26 psychiatrists receiving at least $1000 from top antipsychotic manufacturers in 2010, 7 (27%) were Medicaid providers. Medicaid psychiatrists, however, received a disproportionate, share of industry largesse, receiving two-thirds (66%) of gifts and payments. In 2008 (the most recent data available),antipsychotic use by Medicaid recipients was especially high in the nation's capitol, with approximately 1 in 10 recipients receiving a prescription -- a rate five times higher than the total national population.

A large proportion of Medicaid recipients are children under the age of 18. Antipsychotics can cause sedation, weight gain, diabetes, and other adverse effects. Previous studies have shown a high rate of inappropriate off-label use (for conditions the FDA has not approved). Some adverse events may be more likely to occur in children and young adults.

Lead researcher Susan Wood, PhD, Associate Professor at SPHHS, said, "Pharmaceutical marketing affects which drugs are prescribed. Prescribing decisions can have a profound effect on both state coffers and population health."

"Antipsychotics are clearly being used in patients who are not psychotic," said Adriane Fugh-Berman, MD, collaborator on the report and Associate Professor of Pharmacology and Physiology at Georgetown University Medical Center.

The report is in fulfillment of AccessRx, the District of Columbia's 2006 law requiring public disclosure of pharmaceutical marketing expenditures spent on all health care providers by every pharmaceutical company that markets in the District. The DOH's Health Regulation and Licensing Administration commissioned the study by SPHHS on the 2010 data. The amounts paid by antipsychotic manufacturers to DC Medicaid and non-Medicaid psychiatrists are included in the report, along with the effects of the new public records on prescribing and marketing trends.

Access to the report is available on DOH's web site, http://doh.dc.gov/node/158762