Matt S.
10-29-07, 01:12 PM
Several Treatments Show Efficacy in Kids With ADHD
Mark Moran
Four reports in the August JAACAP from the Multimodal Treatment Study of Children With ADHD begin to give a clearer picture of the longer-term outcomes of these youngsters.
Children with ADHD treated for 14 months in a study comparing four kinds of treatment all showed improvement in the core symptoms of ADHD nearly two years after the study ended. The treatments were medication management, behavior therapy, a combination of medication management and behavior therapy, and usual care in the community.
That was the central finding from a 36-month follow-up of children treated in the Multimodal Treatment Study of Children With ADHD (MTA), an NIMH-funded project comparing a variety of treatments for ADHD for children aged 7 to 10.
The study, "Three-Year Follow-Up of the NIMH MTA Study," was one of four appearing in the August Journal of the American Academy of Child and Adolescent Medicare programs experienced serious barriers after their prescription-drug coverage was moved from Medicaid to Medicare Part D at the start of 2006. Approximately 2 million dual-eligible beneficiaries are estimated to have mental illness (Psychiatric News, July 20). Data on the first four months of the transition were reported in the May American Journal of Psychiatry, and data on the remainder of the year were announced at APA's 2007 annual meeting. The report concluded that access obstacles identified in the first four months of the transition continued throughout the rest of the year and in some cases worsened.
The APIRE study, which was based on responses from a nationwide sample of psychiatrists, was the first to compile clinically detailed, national data on the impact of drug-plan management practices under Part D on dual-eligible psychiatric patients' medication access, treatment compliance, and clinical outcomes.
The proposed legislation "supports a series of efforts by APA to study beneficiary access to psychiatric medications under Medicare and to protect the availability of these medications within the Medicare program," Robinowitz said.
Insurer Actions Limited
The legislation would bar several insurer actions that the APIRE study found were widespread. These include use of utilization-management tools such as prior authorization and step therapy for medications within the six specified drug classes.
Moreover, the bill would require insurers to provide temporary coverage of medications within any of the six protected classes after the PDP has denied initial coverage. Temporary coverage would continue during the appeals process, or up to 60 days following notice of the denial-of-coverage decision. Additionally, beneficiaries could request an independent review to examine a denial of coverage for drugs within the six protected classes. Newly approved medications within the six protected classes must be covered within 30 days of Food and Drug Administration approval. http://pn.psychiatryonline.org/cgi/content/full/42/16/1-a?maxtoshow=&HITS=80&hits=80&RESULTFORMAT=&searchid=1&FIRSTINDEX=0&displaysectionid=Clinical+&resourcetype=HWCIT
Mark Moran
Four reports in the August JAACAP from the Multimodal Treatment Study of Children With ADHD begin to give a clearer picture of the longer-term outcomes of these youngsters.
Children with ADHD treated for 14 months in a study comparing four kinds of treatment all showed improvement in the core symptoms of ADHD nearly two years after the study ended. The treatments were medication management, behavior therapy, a combination of medication management and behavior therapy, and usual care in the community.
That was the central finding from a 36-month follow-up of children treated in the Multimodal Treatment Study of Children With ADHD (MTA), an NIMH-funded project comparing a variety of treatments for ADHD for children aged 7 to 10.
The study, "Three-Year Follow-Up of the NIMH MTA Study," was one of four appearing in the August Journal of the American Academy of Child and Adolescent Medicare programs experienced serious barriers after their prescription-drug coverage was moved from Medicaid to Medicare Part D at the start of 2006. Approximately 2 million dual-eligible beneficiaries are estimated to have mental illness (Psychiatric News, July 20). Data on the first four months of the transition were reported in the May American Journal of Psychiatry, and data on the remainder of the year were announced at APA's 2007 annual meeting. The report concluded that access obstacles identified in the first four months of the transition continued throughout the rest of the year and in some cases worsened.
The APIRE study, which was based on responses from a nationwide sample of psychiatrists, was the first to compile clinically detailed, national data on the impact of drug-plan management practices under Part D on dual-eligible psychiatric patients' medication access, treatment compliance, and clinical outcomes.
The proposed legislation "supports a series of efforts by APA to study beneficiary access to psychiatric medications under Medicare and to protect the availability of these medications within the Medicare program," Robinowitz said.
Insurer Actions Limited
The legislation would bar several insurer actions that the APIRE study found were widespread. These include use of utilization-management tools such as prior authorization and step therapy for medications within the six specified drug classes.
Moreover, the bill would require insurers to provide temporary coverage of medications within any of the six protected classes after the PDP has denied initial coverage. Temporary coverage would continue during the appeals process, or up to 60 days following notice of the denial-of-coverage decision. Additionally, beneficiaries could request an independent review to examine a denial of coverage for drugs within the six protected classes. Newly approved medications within the six protected classes must be covered within 30 days of Food and Drug Administration approval. http://pn.psychiatryonline.org/cgi/content/full/42/16/1-a?maxtoshow=&HITS=80&hits=80&RESULTFORMAT=&searchid=1&FIRSTINDEX=0&displaysectionid=Clinical+&resourcetype=HWCIT