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N.C. Medicaid Goes Online to Monitor Kids’ Mental Health Drugs

For release: Immediate    October 24, 2011
Contact: Brad Deen, (919) 855-4840

RALEIGH — N.C. Medicaid has launched a new, high-tech program to safeguard the health of children prescribed antipsychotic medications, while shaving an estimated $30 million from the state’s Medicaid budgets over the next five years.

Antipsychotics—Keep It Documented for Safety, or A+KIDS, is a web-based tool for physicians who prescribe an antipsychotic drug to a Medicaid recipient under age 18. A+KIDS was created in response to sharp increases in antipsychotic medications prescribed for children, and to growing concerns about side effects, particularly in children.

“The clinical concern with the frequent use of antipsychotic medications in children is nationwide.” said Dr. Randall Best, chief medical officer for N.C. Medicaid.

Although many children benefit from these powerful medications, questions of overprescribing and undermonitoring are being raised in the pediatric and mental-health fields. Increasing numbers of medical reports have identified severe, long-lasting side effects in children—from neurological (tremors and stiffness) to metabolic (rapid weight gain, leading to related disorders such as high cholesterol and diabetes).

In 2010, more than 20,000 N.C. Medicaid enrollees under age 18 were prescribed an antipsychotic medication, at a cost exceeding $40 million. DHHS has limited legislative authority to restrict prescribing of this class of drugs.

A+KIDS ensures physicians have information on antipsychotic medications, side effects and possible alternatives before writing the prescription. The online registry makes that information available while the physician enters diagnoses and other health factors relating to the young Medicaid patient.

“In North Carolina, we are not creating an undue burden on providers,” Dr. Best said, “while ensuring adequate safety monitoring consistent with the ‘first, do no harm’ principle of medicine.”

Other states have already begun to contact N.C. Medicaid about its experiences with A+KIDS.

Key partners with DHHS in the A+KIDS endeavor include the Community Care of North Carolina (CCNC) managed-care networks for Medicaid recipients, and an advisory group of child mental health experts from the state’s four medical schools.

Although health and safety concerns are the primary drivers in the creation of A+KIDS, budgetary savings exceeding $30 million over the next five years are projected:

State Fiscal Year Projected Savings
2011-12 $862,500
2012-13 $4,657,500
2013-14 $8,048,160
2014-15 $8,692,013
2015-16 $9,387,374
5-year total $31,647,547

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