Access and Utilization of New Antidepressant and Antipsychotic Medications. C. Utilization of Newer Antidepressant and Antipsychotic Medications by State Medicaid Programs 1995-1998


New generation antipsychotics and antidepressants have been accepted into common use within Medicaid programs.

  • In 1998, 51% of the 11 million Medicaid antipsychotic prescriptions were for atypicals.
    • In contrast, atypicals accounted for 17.5% of 9.1 million Medicaid antipsychotic prescriptions in 1995.
  • In 1998, 62% of the 19 million Medicaid antidepressant prescriptions were for new-generation, branded antidepressants.
    • In contrast, new generation antidepressants accounted for 44% of 13.6 million Medicaid antidepressant prescriptions in 1995.

The introduction of atypical antipsychotics and new-generation antidepressants has been accompanied by a growth in the total market for antipsychotics and antidepressants in Medicaid.

  • The growth in both number of prescriptions for and cost of antidepressants and antipsychotics outpaces that of the aggregate by more than 2-fold.

Antidepressants and antipsychotics account for nearly 9% of Medicaid pharmaceutical prescriptions and nearly 19% of Medicaid pharmaceutical reimbursements.

  • Although the number of all prescriptions (i.e., from any therapeutic category) reimbursed by Medicaid has remained relatively constant between 1995 and 1998, expenditures have increased by over 40%.
  • Prescriptions for antipsychotics grew 11% between 1995 and 1998 while expenditures increased by more than 160%.
    • Total Medicaid spending on antipsychotics exceeded $1.3 billion in 1998.
    • Uptake of atypical antipsychotics is driving pharmacy costs for this class.
  • Prescriptions for antidepressants grew 40% between 1995 and 1998 while expenditures increased by approximately 96%.
    • Total Medicaid spending on antidepressants reached $985 million in 1998.
    • Increased numbers of prescriptions together with uptake of new-generation antidepressants is driving pharmacy costs for this class.

New-generation antidepressants and antipsychotics have been accepted into common use by Medicaid programs at about the same rate and to the same extent as other innovator drugs.