Cost Control Measures Limit Patient and Physician Choice in Psychotropic Medications

http://www.docguide.com/news/content...257291006FF002

Cost Control Measures Limit Patient and Physician Choice in Psychotropic
Medications
WALTHAM, MA -- March 1, 2007 -- A new study suggests that private health
plans increasingly rely on escalating copayments to manage drug costs, as
opposed to administrative controls.

This makes treatment more expensive in many cases for patients, and may
affect adherence to treatment, said lead author Dominic Hodgkin, PhD,
associate professor at the Schneider Institute for Behavioral Health, Heller
School for Social Policy and Management at Brandeis University. The study is
in the current issue of Clinical Therapeutics.

In the past decade, health insurers have increasingly turned to cost
controls to manage prescription drug use, but little is known about how such
policies affect the use of psychotropic drugs, said Hodgkin.

Between 1996 and 2001, psychotropic drug use to treat psychiatric disorders
climbed from 5.9% to 8.1% of the U.S. population. Newer, better tolerated
drugs account for some of the growth; however, because they are often more
expensive than more established treatments, psychotropic drug spending has
skyrocketed, from an estimated $3.7 billion in 1991 to $18 billion in 2001.

"This growth has raised concern among public and private health care payers,
who have responded with cost-containment policies that affect the choices of
patients and physicians," explained Hodgkin. The study evaluated brand
antidepressants, antipsychotics and drugs used to treat ADHD.

Medicaid programs, by contrast, rely on administrative controls to manage
psychotropic drug costs. These controls include prior authorization by a
physician before a patient can switch to a non-preferred drug at the same
copayment level. Further complicating the picture, patient non-compliance
rates are high for psychotropic drugs such as antidepressants and treatments
for schizophrenia.

The study evaluated a nationally representative survey of private health
plans regarding mental health and substance abuse services. Most plans
covered at least 2 antidepressants and at least 2 antipsychotic drugs at a
medium copayment (averaging $21) that gave the physician some leeway in
choosing the initial medication. However, in many plans patients who did not
respond to one of those drugs faced a substantial hike in copayment (to an
average of $38) in order to try a potentially more effective drug. Coverage
of drugs for ADHD was more restrictive.

The study was funded by grants from the National Institute on Alcohol Abuse
and Alcoholism and the National Institute on Drug Abuse.


SOURCE: Brandeis University

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http://www.docguide.com/news/content...257291006FF002

Cost Control Measures Limit Patient and Physician Choice in Psychotropic
Medications
WALTHAM, MA -- March 1, 2007 -- A new study suggests that private health
plans increasingly rely on escalating copayments to manage drug costs, as
opposed to administrative controls.

This makes treatment more expensive in many cases for patients, and may
affect adherence to treatment, said lead author Dominic Hodgkin, PhD,
associate professor at the Schneider Institute for Behavioral Health,
Heller School for Social Policy and Management at Brandeis University. The
study is in the current issue of Clinical Therapeutics.

In the past decade, health insurers have increasingly turned to cost
controls to manage prescription drug use, but little is known about how
such policies affect the use of psychotropic drugs, said Hodgkin.

Between 1996 and 2001, psychotropic drug use to treat psychiatric
disorders climbed from 5.9% to 8.1% of the U.S. population. Newer, better
tolerated drugs account for some of the growth; however, because they are
often more expensive than more established treatments, psychotropic drug
spending has skyrocketed, from an estimated $3.7 billion in 1991 to $18
billion in 2001.

"This growth has raised concern among public and private health care
payers, who have responded with cost-containment policies that affect the
choices of patients and physicians," explained Hodgkin. The study
evaluated brand antidepressants, antipsychotics and drugs used to treat
ADHD.

Medicaid programs, by contrast, rely on administrative controls to manage
psychotropic drug costs. These controls include prior authorization by a
physician before a patient can switch to a non-preferred drug at the same
copayment level. Further complicating the picture, patient non-compliance
rates are high for psychotropic drugs such as antidepressants and
treatments for schizophrenia.


This is not only true for psychotropic medications, but for most medicaitons
across the disease spectrum.
The study evaluated a nationally representative survey of private health
plans regarding mental health and substance abuse services. Most plans
covered at least 2 antidepressants and at least 2 antipsychotic drugs at a
medium copayment (averaging $21) that gave the physician some leeway in
choosing the initial medication. However, in many plans patients who did
not respond to one of those drugs faced a substantial hike in copayment
(to an average of $38) in order to try a potentially more effective drug.
Coverage of drugs for ADHD was more restrictive.

The study was funded by grants from the National Institute on Alcohol
Abuse and Alcoholism and the National Institute on Drug Abuse.


SOURCE: Brandeis University