NAMI’s Position (taken from the NAMI Policy Platform)
NAMI strongly opposes measures that limit the availability and right of individuals with brain disorders to receive treatment with "new generation" medications.
Understanding the Issue:
NAMI members strongly support research to discover a cure for severe brain disorders. Until then, more than anyone else, NAMI consumers and families recognize the need for medications that can control the symptoms of these brain disorders.
NAMI believes that professional judgment and informed consumer choice should determine the choice of medications. Choice of treatments should be based on our knowledge of effectiveness and side effects and should be consistent with existing treatment guidelines.
Medications for mental illnesses differ from one another - either in their effectiveness in treating specific symptoms or disorders, or in their side effects. There is ample evidence that newer medications offer some advantages over conventional medications in either effectiveness or side effects. For example, most guidelines now recommend newer antipsychotic medications as the drugs of first choice because they can be more effective in treating symptoms in some individuals and because their side effects may cause fewer short-term and long-term problems - and in particular, fewer cases of tardive dyskinesia, an irreversible and potentially disabling movement disorder.
However, some health plans, both private and public sector, place restrictions on access to medications. Sometimes these policies may be appropriate, to avoid the inappropriate use of drugs or to encourage the use of generic equivalents. But often the limitations are designed primarily to discourage the use of more expensive medications. Limitations may take the form of a restricted formulary, in which only certain medications are covered by the plan, or a "fail-first" policy, requiring trials of older, less expensive medications before prescribing newer medications.
NAMI members are committed to work to identify and remove any barriers that prevent persons with severe brain disorders from receiving "the right medication, at the right dose, at the right frequency, and for the right duration." NAMI members understand that the right medication is not only right for the consumer, it is also right for the payer and the health plan - there is growing evidence that access to newer medications may reduce the total cost of the illness by reducing other medical expenses such as hospitalization, by improving compliance, and by reducing disability.
NAMI is supportive of many of the provisions contained in the separate House and Senate managed care patient Bill of Rights proposals. In particular, NAMI supports: