Boston Globe Examines Impact of Neurontin Sales on States’ Medicaid Costs

The Boston Globe on Nov. 25 examined the anticonvulsant drug Neurontin, whose "soaring" sales -- physicians wrote 14 million prescriptions last year -- make the drug "a case study" in why state Medicaid programs are "overwhelmed." Neurontin, whose "widespread use" by Massachusetts' Medicaid program has prompted a state investigation, was approved by the FDA only for epilepsy and for shingles pain. However, 80% of the time, the drug is prescribed for a "vast host" of psychiatric conditions and neuropathic pain. With "few side effects," the drug is "mild" and non-addictive, the Globe reports. According to Dr. Sami Harik, head of neurology at the University of Arkansas College of Medicine, "Neurontin is a useful drug, especially in painful conditions, but it's being used for everything and everybody." However, the drug is expensive and has "hit state Medicaid programs and private insurers hard," the Globe reports. In 2002, Massachusetts spent $25 million on Neurontin, up from $3 million in 1998. Ohio's Medicaid program this year spent $24 million on the drug, twice as much as it spent two years ago, and costs under Florida's Medicaid program for the drug tripled to $15 million between 1998 and 2001. The Globe reports that "aggressive marketing" by Neurontin manufacturer Parke-Davis, now owned by Pfizer, has made the drug company "a lot of money," but it is also now the subject of a federal and multistate investigation and a whistle-blower lawsuit in Boston. The Globe reports that Massachusetts will soon warn 5,000 physicians to "cut down" on "inappropriate" use of the drug (Kowalczyk, Boston Globe, 11/25).