National Alliance on Mental Illness
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Oregon’s Center for Evidence-Based Practice Program
The Center for Evidence-based Practice (Center) is directed by former Oregon Governor John Kitzhaber. It is a collaboration between the Oregon Health Sciences University (OHSU), which contracts with three Evidence-based Centers (designated by the federal Agency for Health Care Research and Quality) at UCLA, UNC and OHSU for review of existing studies comparing drugs within a therapeutic class. The Center states that its purpose is to "promote collaboration among citizens, non-profit organizations, business, labor, research and government entities" on policy solutions.
The first project of the Center is the "Drug Effectiveness Review Project", which aims to conduct wide-ranging reviews of all available research on classes of medications and determine the "best" therapies in those classes based on the evidence from clinical studies, journaled comparative analyses and even manufacturer dossiers. However, the group's literature also notes that when studies are inconclusive about obvious "best choice" among therapies in a class, the cheapest option will be favored for a preferred drug list.
The Center is approaching Medicaid agencies in reportedly over a dozen states who, for $100,000 (which has to come from State General Fund dollars), will gain access to this scientific review of evidence and obtain guidance regarding which medications have an "evidence base" to be included in preferred drug lists (PDLs).
The Center has not done any evaluation of mental health medication classes to date; however, draft recommendations for antidepressants (SSRIs) may be submitted to independent reviewers by the end of May 2004.
NAMI advocates are asked to monitor closely potential initiatives in their state Medicaid programs that would incorporate the Center’s recommendations. If the state Medicaid program is holding discussions with the Center, please use the issues highlighted in the letter that NAMI sent to the Center, to express your affiliate’s concerns directly to Medicaid officials in your state. Click here to read the letter.