Access and Utilization of New Antidepressant and Antipsychotic Medications. Expert Interviews


The Lewin Group identified a set of key topics and issues that affect access to and utilization of antidepressant and antipsychotic medications that were not adequately discussed in the literature. These topics included, but were not restricted to:

  • Inclusion or exclusion of specific medications from the approved formulary lists;
  • Pre-Authorization requirements for specific medications;
  • Choice of preferred or first-line medications and the reasons for these choices;
  • Generic or therapeutic substitution practices;
  • Restrictions or variations in prescriber credentialling;
  • Coordination of benefits between inpatient and outpatient services;
  • Policies requiring patients to accept medication as a condition for psychotherapy, or otherwise restricting access to psychotherapy; and
  • Allowances for provider and patient choice in medications.

The interview guides and survey instruments developed for this data collection are included in Appendix A. Exhibit I-3 presents the respondent organizations interviewed for this study. A fuller discussion of rationale for choosing each respondent is presented in Appendix B. A full list of all respondents is included in Appendix C.

Exhibit I-3. List of Key Informants

Key Informants Number of Site Visits Number of Telephone Interviews
Pharmaceutical companies 3 2
Managed behavioral health care companies 1 2
Large health maintenance organizations 2 3
Pharmacy Benefit Managers   5
Employers   3
Federal Programs   2
State Medicaid Programs   4
Department of Defense 1 1
Veterans Administration 1 1
State Mental Health Systems   4
Provider Associations 2  
Consumer and Advocacy Associations 2  
Totals 12 25