Access and Utilization of New Antidepressant and Antipsychotic Medications. B. Trends in Medicaid Pharmaceutical Coverage


Total prescriptions in Medicaid were relatively flat between 1995 and 1998. Medicaid programs reimbursed 327 million prescriptions in 1995 and 331 million prescriptions in 1998. During the same period, antipsychotic prescriptions increased by nearly 20% while antidepressant prescriptions increased by just over 40%.

However, prescription expenditures increased by 43% between 1995 and 1998. Medicaid programs paid almost $8.9 billion for prescription drugs in 1995 and $12.8 billion in 1998. During the same period, expenditures on antipsychotics increased by approximately 160%, while prescriptions for antidepressants increased by 96%.

In 1998, the 11 million Medicaid antipsychotic prescriptions accounted for only 3% of all Medicaid prescriptions. However, the $1.3 billion spent for these pharmaceuticals represented nearly 11% of total expenditures. Similarly, the 19 million antidepressant prescriptions accounted for nearly 6% of total prescriptions, while the $985 million spent for these agents approached 8% of expenditures. Therefore, although antidepressants and antipsychotics account for nearly 9% of total Medicaid prescriptions in 1998, their impact to total pharmaceutical costs is nearly twice as large as their market share.