Med Services Update
Magellan Approves New Technology for Drug-Facilitated Interviews for the Treatment of Catatonia
A considerable volume of emerging technologies and new applications of current technologies exists in all fields of medicine. The behavioral health field is no exception.
Recently, a Magellan corporate task force reviewed the use of drug-facilitated interviews for the treatment of three diagnoses:
- Dissociative disorder
- Posttraumatic stress disorder (PTSD)
- Catatonia.
The task force also reviewed the use of vagus nerve stimulation (VNS) for treatment-resistant depression.
Conclusions
Magellan concluded the following:
- The drug-facilitated interview using intravenous amobarbital in the urgent diagnosis and treatment of patients presenting with catatonia has been established for accurate and prompt diagnosis of catatonia, which is crucial to prevent morbidity and death in a variety of emergency medicine, psychiatric, neurological, medical, obstetric, and surgical settings and to institute effective interventions.
- At this time, the use of drug-facilitated interviews with abreaction in the treatment of both dissociative disorder and PTSD is considered to be an investigational procedure that currently is not widespread in use.
- While the technology of VNS appears promising, evidence thus far remains limited (i.e., only one randomized controlled study published) and does not yet clearly demonstrate that this is an established treatment for depression. For this reason, VNS for treatment-resistant depression remains investigational at this time.
The Technology Assessment Committee will review the technologies found to be investigational again when further studies on their efficacy have been conducted.
Technology Assessment Process
By policy, Magellan conducts new technology assessments proactively and in response to requests from our regional care management centers or from our network practitioners. We do this through one of the following two processes, applying the same criteria in making each technology assessment decision.
Case-Specific Utilization Management (UM) Decision-Making Process
The Magellan care management center vice president of medical services renders a determination in consultation with his/her clinical review team on a specific case. These are time-sensitive decisions at the point of a request for service.
Technology-Specific Written Report Processes
- Magellan Care Management Center Task Force - The center’s vice president of medical services, after registering the request with Magellan’s senior vice president of medical services and chief medical officer, chairs a task force to conduct a technology assessment relevant to multiple requests in that region and/or in response to a regional customer request.
- Corporate Task Force – Magellan’s chief medical officer appoints a Corporate Task Force to conduct a technology assessment on a new technology that appears to have scientific literature/government agency support, is frequently presented at multiple regions throughout the country in treatment plans, and/or is being requested by corporate customers.