Psychoactive medications are the most expensive and fastest-growing class of pharmaceutical agents for children. The cost, side effects, and unprecedented growth rate at which these drugs are prescribed has raised alarms from health care clinicians, patient advocates, and agencies about the appropriateness of how these drugs are distributed to parents and their children.
The authors of a newly released paper in the Think Bigger Do Good Policy Series reviews the current prescribing of three classes of psychoactive drug (stimulants, antidepressants, and antipsychotics) and efforts to improve pediatric prescribing of these.
Authors, Kelly J. Kelleher, M.D., M.P.H., David Rubin, M.D., M.S.C.E., Kimberly Hoagwood, Ph.D., call for system level interventions and in federal and state policies to address this growing utilization of psychoactive medications. Their recommendations include:
-Increasing the access to and improving the quality of psychotherapy services as an alternative to psychoactive medications. 
-Standardization of treatment protocols and increased emphasis on the value of shared decision making between providers and caregivers.
-The creation of and further implementation of state or insurance company monitoring programs that review prescribing data both retrospectively or prospectively and, in some cases, have peer to peer monitoring by prescribers.
-Greater transparency in prices and incentives among insurers, public agencies, and pharmacy benefit managers.
-Requiring direct negotiations between state Medicaid agencies and drug manufacturers to reduce costs and inappropriate incentives.
-Payment for outcomes related to costs through the larger adoption of value-based purchasing and specifically value-based payment for medications.
We ask that you send the paper to your local, state, and/or federal policy and decision-makers, to advocate for policy reforms and restructured financing models to increase access to integrated behavioral health services.