To "cut costs and reduce questionable prescriptions," 20 U.S. states contract with Comprehensive NeuroScience (CNS). CNS "identifies doctors who are prescribing psychiatric drugs outside of recommended guidelines. ... The states then send warning letters to doctors." In Minnesota, the CNS contract is funded by the drug company Eli Lilly. Lilly makes the "top-selling antipsychotic drug" Zyprexa. Minnesota spent $28 million on Zyprexa for poor and disabled residents in 2005. Unlike other states, Minnesota does not require prior authorization for antipsychotic drugs, a practice that Lilly opposes. "In fact," reports the Pioneer Press, "none of the states with Lilly partnerships use prior authorization to manage antipsychotic drugs. ... Wisconsin had a contract with Lilly last year, when the state's Medicaid agency placed antipsychotic drugs, including Zyprexa, on the prior authorization list. State officials were informed shortly thereafter that Lilly was canceling the program." Minnesota also requires "dose optimization" -- often resulting in less profit for drug manufacturers -- for other antipsychotic medications, but not for Zyprexa.
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