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Caution, but at What Cost?
Requiring prior authorization from insurance companies before prescribing schizophrenia medications undermines treatment without cutting costs, according to a Harvard study published this week.
Many health plans, including some state Medicaid programs, delay prescriptions of antipsychotic drugs used to treat schizophrenia until doctors have submitted a form indicating that other therapies have failed or that the drugs are medically necessary.
The researchers compared outcomes for similar schizophrenic patients under a Maine prior authorization plan and a New Hampshire plan without the provision.
Though the costs of coverage were nearly identical, Maine patients were almost a third more likely to suffer gaps in treatment, which can lead to deteriorating health and hospitalization.
The study received some of its funding from Eli Lilly and Co., a pharmaceutical company that makes one of the drugs affected by prior authorization requirements.
While the research dealt with only one form of the learning disorder, the study’s authors wrote that their findings could have broader applications as a potential model for investigating other brain function disorders.two.
Rising to the Occasion
Harvard researchers discovered a new form of eyesight for one species of River House resident when they found a special type of cell in mice that detects upward motion.
The researchers, neuroscientists Joshua R. Sanes and Markus Meister, also found a certain molecule at far higher concentrations in the new cells than their neighbors, suggesting a role for the molecule in determining cell fate.
Sanes and Meister wrote that they hoped the finding would help shed light on how brain cells develop as well as how the brain identifies its sources of sensory information.
But a nagging question still has them stumped.
“Why in the world would mice need to develop cells to detect upward motion?” Sanes said in a statement. “It’s a great mystery.”broader applications as a potential model for investigating other brain function disorders.
Boning Up on Organ Transplants
Children dying of cancer experience better quality of life than they did a decade ago, according to a new Harvard study, which suggests changes in care have improved end-of-life experiences for young patients.
The study compared two groups of 100 terminally-ill children—one was studied from 1990 to 1997 and another from 1997 to 2004—and found that parents in the latter group reported they felt more prepared for their child’s death and that their children suffered less.
Study author Joanne Wolf attributed the improvements to a concurrent increase in palliative care—treatments that seek to alleviate suffering rather than cure disease. The study showed that the second group had earlier discussions of end-of-life palliative care and made greater use of do-not-resuscitate orders.
Wolf concludes by predicting that “with ongoing growth of the field of hospice and palliative medicine, further advancements are likely.”
For recent research, faculty profiles, and a look at the issues facing Harvard scientists, check out The Crimson's science page.
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