TennCare dropped two drugs important to treat seizures

Most Tennesseans now recognize that TennCare reforms are here to stay and that those reforms will require tough decisions from the state and hardship on some TennCare enrollees.

But Tennesseans still should demand that tough decisions are also smart decisions. That may not be the case with a recent decision on two classifications of drugs.

Last month, TennCare dropped benzodiazepines, such as Valium, and barbiturates, such as Nembutal, from the pharmacy benefit. The move puts Tennessee in line with the federal Medicare program, which dropped the two categories on Jan. 1 at the insistence of Congress.

Most of the drugs in these categories have been on the market for years and are available in low-cost generic forms. A TennCare spokeswoman said that the drugs were very inexpensive and that patients could buy them. She said that continuing to provide them through TennCare would add administrative costs because of the new federal guidelines. TennCare also says that the drugs can be highly addictive and over-prescribed, and that the substitutes are safer.

But the pharmacy committee appointed to advise TennCare wasn't consulted before the drugs were dropped, and its members say the drugs are the most effective ones for certain conditions.
The reasons cited by TennCare for dropping the drugs seem petty next to the physical impact suffered by those people who need them, including people with epilepsy, cerebral palsy and mental retardation. One Nashville doctor said that withdrawal from the drugs could be fatal. Another doctor who treats epilepsy patients says there is no substitute for benzodiazepines in treating prolonged seizures.

TennCare is all alone on this decision: It doesn't have the backing of its own pharmacy committee. And the health-care programs for the poor in every other state continue to provide these drugs.
That could make Tennessee a leader — or it could mean Tennessee is just wrong. It would be a costly mistake for the program, and a devastating one to the people who need these drugs.