Deval L. Patrick governor timothy p. Murray lieutenant Governor



Download 27.82 Kb.
Date conversion29.04.2016
Size27.82 Kb.

DEVAL L. PATRICK Governor

TIMOTHY P. MURRAY Lieutenant Governor

The Commonwealth of Massachusetts

Executive Office of Health and Human Services

Office of Medicaid

One Ashburton Place

Boston, MA 02108

JUDYANN BIGBY, M.D. Secretary

TERENCE G. DOUGHERTY Interim Medicaid Director


Dear Prescriber,

November 2009



MassHealth and the Massachusetts Department of Mental Health are writing to you about the prescribing of paliperidone (Invega®) for some of your MassHealth patients. We hope that this information is useful to you and your patient(s).

Comparison Table




risperidone

paliperidone

Chemical structure

Parent drug of paliperidone 1,2,3

Active metabolite of

risperidone1,2,3

Side effect profile

No demonstrated difference from

paliperidone*1,2,3

No demonstrated difference from

risperidone*1,2,3

Clinical efficacy

No demonstrated difference from paliperidone*

No demonstrated difference from risperidone*

Cost of 30-day prescription 4mg risperdone vs. 9mg paliperidone

$36

$274

Projected yearly cost (MassHealth)

$3.5 million for 98,600 prescriptions

$2.2 million for 8,000 prescriptions

*The dose of risperidone is adjusted as needed for patient-specific metabolizing rate.

An extensive review of the literature does not support any clinically significant differences between paliperidone and risperidone. The two medications share a very similar pharmacological structure and profile. Typically, when medications are so structurally similar, a “head-to-head” trial is considered the “gold standard” for identifying differences between them. In this instance, no such studies have been conducted.

We have attached a list of your MassHealth patients who are currently prescribed paliperidone. Please review your cases carefully, and as clinically appropriate, reconsider continuing treatment with paliperidone, a much more costly product than risperidone.



continued

Thank you for joining us in this important and focused effort to help ensure that our members receive medically necessary prescriptions that are safe and effective, and result in high quality and cost-effective care.

Sincerely,


Mary Ellen Foti, MD Paul L. Jeffrey, PharmD

Deputy Commissioner Senior Director

Clinical and Professional Services Office of Clinical Affairs

Massachusetts Department of Mental Health Director of Pharmacy

MassHealth



1. The Carlat Psychiatry Report. March 2007;5(3)

http://www.thecarlatreport.com/index.asp?page=wp3152007185348 (accessed June 2009)

2. Dolder C, Nelson M, Deyo Z. Paliperidone for schizophrenia. Am J Health-Syst
Pharm. 2008;65:403-413.

3. Marino J, Caballero J. Paliperidone extended-release for the treatment of
schizophrenia. Pharmacotherapy 2008;28:1283-1298.


The database is protected by copyright ©essaydocs.org 2016
send message

    Main page