COLUMBIA, S.C. — South Carolina state senators voted Tuesday to require the state’s poorest residents to first try generic drugs to treat cancer, HIV/AIDS and mental illness if a generic is available.

If the generic drugs are not effective, their doctor then could prescribe a name-brand drug.

State spending on drugs for Medicaid recipients has been a hot topic this legislative session, particularly spending on atypical antipsychotic drugs that are used to treat a wide range of mental illnesses, including bipolar disorder and schizophrenia. Some research says the drugs are overprescribed, may cause dangerous side effects and, for some patients, are no more effective than cheaper, generic drugs and treatments.

But since 2004, state lawmakers have voted to include a rule in the state budget — called a proviso — allowing physicians to prescribe any atypical antipsychotic drug to Medicaid recipients they choose, even if there is a generic or other drug that costs less that may work just as well.

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