Whenever I hear about States funding disease management programs with money from pharmaceutical companies I get a little queasy. It feels like having the fox design and build the hen house.

In this article Melody Petersen tells us about how pharmaceutical companies helped pay for development of guidelines that recommend new drugs for the treatment of schizophrenia—drugs that cost $3,000 per year per person, instead of $250. “A Johnson and Johnson subsidiary that sells Risperdal, paid $4,000 to fly two state mental health officials to New Orleans, where they dined at an elegant Creole restaurant in the French Quarter, visited the aquarium and met with company executives and Texas officials,” she reports.

State governments are the biggest purchasers of antipsychotic drugs, since they pay for Medicaid and state mental hospitals and outpatient clinics. Being part of a treatment guideline can result in billions of dollars of sales.