The exclusion of benzodiazepine coverage in medicare: Simple steps for avoiding a public health crisis

Psychiatric Services

Volumn 56, Issue 9, 2005, Pages 1143-1146

  Bambauer, Kara Zivin ^a   Sabin, James E ^a   Soumerai, Stephen B ^a,b  

^a HARVARD MEDICAL SCHOOL   (United States)

^b NONE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

BENZODIAZEPINE DERIVATIVE;

DRUG ABUSE; DRUG COST; DRUG USE; HEALTH CARE POLICY; HISTORY; HUMAN; LAW; MEDICARE; MENTAL DISEASE; PUBLIC HEALTH; REIMBURSEMENT; SHORT SURVEY; WITHDRAWAL SYNDROME;

BENZODIAZEPINES; COST-BENEFIT ANALYSIS; CRISIS INTERVENTION; HEALTH PRIORITIES; HEALTH SERVICES NEEDS AND DEMAND; HUMANS; INSURANCE, PHARMACEUTICAL SERVICES; MEDICARE; MENTAL DISORDERS; UNITED STATES;

EID: 24644511095     PISSN: 10752730     EISSN: None     Source Type: Journal    
DOI: 10.1176/appi.ps.56.9.1143     Document Type: Short Survey

References (43)

1. Ross-Degnan D, Simoni-Wastila L, Brown JS, et al: A controlled study of the effects of state surveillance on indicators of problematic and non-problematic benzodiazepine use in a Medicaid population. International Journal of Psychiatry in Medicine 34: 103-123, 2004
2. Wagner AK, Zhang F, Soumerai SB, et al: Benzodiazepine use and hip fractures in the elderly: who is at greatest risk? Archives of Internal Medicine 164:1567-1572, 2004
3. Comments to CMS on Proposed Rule for Title 1 of MMA. Alexandria, Va, American Society of Consultant Pharmacists, 2004. Available at www.ascp.com/medicarerx/docs/ascp_cms_mma_comments.pdf.
4. Critical Coverage: Benzodiazepines Under Medicare Part D. New York, Medicare Rights Center, 2005. Available at www.medicarerights.org/benzoreport. pdf.
5. History of the Medicaid Drug Rebate Program. Baltimore, Centers for Medicare and Medicaid Services (CMS). Available at www.cms.hhs.gov/medicaid/ drugs/mrphistory.asp. Accessed June 9, 2005
6. National Pharmaceutical Council: Pharmaceutical Benefits Under State Medical Assistance Programs, 2003. Available at www.npcnow.org/resources/ pharmbenefits medicaid.asp
7. Rosack J: Medicare prescription benefit excludes benzodiazepiues. Psychiatric News 40:1,50, 2005
8. Health Policy Alternatives Inc: Prescription Drug Coverage for Medicare Beneficiaries: Summary of the Proposed Rule to Implement the Medicare Prescription Drug Benefit (Title I of the Medicare Modernization Act of 2003). Menlo Park, Calif, Henry J Kaiser Family Foundation, 2004. Available at www.kff.org/medicare/6112.cfm.
9. Comments on Medicare Prescription Drug Program. Washington, DC, Alzheimer's Association, 2004. Available at www.alz.org/advocacy/wherewestand/ 20041004_com ments.pdf
10. AMCPs Comment Letter to CMS on Draft Regulations for Medicare Prescription Drug Benefit. Alexandria, Va, Academy of Managed Care Pharmacy, 2004. Available at www.amcp.org/data/legislative/analysis/amcp_percent20medicare percent20com mentpercent201etter percent2epdf
11. Testimony of the Long Term Care Pharmacy Alliance to the Senate Special Committee on Aging. Available at http://aging.sen ate.gov/public/_files/hr17wg. pdf. Accessed June 10, 2005
12. Soumerai SB: Comment Letter to CMS on Draft Regulations for Medicare Prescription Drug Benefit Regarding the Benzodiazepine Exclusion, 2004. Centers for Medicare and Medicaid Services document CMS-4068-P-506. Available at www.cms. hhs.gov/regulations/ecomments/comments page04.asp
13. Gressitt S: Comment Letter to CMS on Draft Regulations for Medicare Prescription Drug Benefit Regarding the Benzodiazepine Exclusion, 2004. Centers for Medicare and Medicaid Services document CMS-4068-P-353. Available at www.cms. hhs.gov/regulations/ecomments/comments page04.asp
14. United States Pharmacopeia Convention I: Medicare Prescription Drug Benefit Model Guidelines: Drug Categories and Classes in Part D. Final Guidelines, 2004. Available at www.ashp.org/medicare/usp%20mod el%20formulary%20guidelines.pdf
15. Fick DM, Cooper JW, Wade WE, et al: Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Archives of Internal Medicine 163:2716-2724, 2003
16. Smith DG: Letter to State Medicaid Directors, SMDL #05-002. Baltimore, Centers for Medicare and Medicaid Services, Center for Medicaid and State Operations, 2005
17. Schneider A: The "Clawback": State Financing of Medicare Drug Coverage. Washington, DC, Henry J Kaiser Family Foundation, 2004. Available at www.kff. org/medicaid/loader.cfm?url=/commonspot/security/getfile. cfm&pageid=39919
18. HR 3151, 109th Cong Section 1(b), 2005
19. Freking K: Medicare Won't Cover Some Anxiety Drugs. Washington, DC, Associated Press, 2005
20. Letter to Representative Benjamin L Cardin supporting the bill to remove the exclusion of benzodiazepine coverage from the Medicare Modernization Act, 2005. Chicago, American Medical Association, 2005
21. Salzman C, Watsky E: Rational prescribing of benzodiazepines, in Benzodiazepine Dependence. Edited by Hallstrom C. Oxford, England, Oxford University Press, 1993
22. Salzman C: Addiction to benzodiazepines. Psychiatric Quarterly 69:251-261, 1998
23. Salzman C: Benefits versus risks of benzodiazepines. Psychiatric Annals 28:139-141, 1998
24. Martinez-Cano H, de Iceta Ibanez de Gauna M, Vela-Bueno A, et al: DSM-III-R comorbidity in benzodiazepine dependence. Addiction 94:97-107, 1999
25. Alldredge BK, Gelb AM, Isaacs SM, et al: A comparison of lorazepam, diazepam, and placebo for the treatment of out-of-hospital status epilepticus. New England Journal of Medicine 345:631-637, 2001
26. Belmaker RH: Bipolar disorder. New England Journal of Medicine 351:476-486, 2004
27. Uhlenhuth EH, Balter MB, Ban TA, et al: International study of expert judgement on therapeutic use of benzodiazepines and other psychotherapeutic medications: V. treatment strategies in panic disorder, 1992-1997. Journal of Clinical Psychopharmacology 18:27S-31S, 1998
28. Salzman C: The benzodiazepine controversy: therapeutic effects versus dependence, withdrawal, and toxicity. Harvard Review of Psychiatry 4:279-282, 1997
29. WHO Model List of Essential Medicines. Geneva, World Health Organization, 2003. Available at www.who.int/medicines/organ ization/par/edl/expcom13/ eml13_en.pdf
30. Medicare Modernization Act - Exclusion of Benzodiazepines. Alexandria, Va, American Society of Consultant Pharmacists. Available at www.ascp.com/medicarerx/docs/mma_benzos.pdf. Accessed June 9, 2005
31. Soumerai SB, Simoni-Wastila L, Singer C, et al: Lack of relationship between long-term use of benzodiazepines and escalation to high dosages. Psychiatric Services 54: 1006-1011, 2003
32. Gleason PP, Schulz R, Smith NL, et al: Correlates and prevalence of benzodiazepine use in community-dwelling elderly. Journal of General Internal Medicine 13:243-250, 1998
33. Valenstein M, Taylor KK, Austin K, et al: Benzodiazepine use among depressed patients treated in mental health settings. American Journal of Psychiatry 161:654-661, 2004
34. Soumerai S: Unintended outcomes of Medicaid drug cost-containment policies on the chronically mentally ill. Journal of Clinical Psychiatry 64(suppl 17):19-22, 2003
35. Soumerai SB: Benefits and risks of increasing restrictions on access to costly drugs in Medicaid. Health Affairs 23:135-146, 2004
36. Soumerai SB, McLaughlin TJ, Ross-Degnan D, et al: Effects limiting Medicaid drug-reimbursement benefits on the use of psychotropic agents and acute mental health services by patients with schizophrenia. New England Journal of Medicine 331:650-655, 1994
37. Soumerai SB, Ross-Degnan D, Avorn J, et al: Effects of Medicaid drug-payment limits on admission to hospitals and nursing homes. New England Journal of Medicine 325:1072-1077, 1991
38. Wagner AK, Soumerai SB, Zhang F, et al: Effects of state surveillance on new post-hospitalization benzodiazepine use. International Journal for Quality in Health Care 15:423-431, 2003
39. Soumerai SB, Ross-Degnan D, Gortmaker S, et al: Withdrawing payment for nonscientific drug therapy: intended and unexpected effects of a large-scale natural experiment. JAMA 263:831-839, 1990
40. Zitman FG, Couvee JE: Chronic benzodiazepine use in general practice patients with depression: an evaluation of controlled treatment and taper-off: report on behalf of the Dutch Chronic Benzodiazepine Working Group. British Journal of Psychiatry 178:317-324, 2001
41. Rector TS, Venus PJ: Do drug benefits help Medicare beneficiaries afford prescribed drugs? Health Affairs 23:213-222, 2004
42. Fortess EE, Soumerai SB, McLaughlin TJ, et al: Utilization of essential medications by vulnerable older people after a drug benefit cap: importance of mental disorders, chronic pain, and practice setting. Journal of the American Geriatrics Society 49: 793-797, 2001
43. Salzman C: An 87-year-old woman taking a benzodiazepine. JAMA 281:1121-1125, 1999