Mental Disability/Illness

Access and Utilization of New Antidepressant and Antipsychotic Medications. A. New Chemical Entities and Generic Competition

The entry of new chemical entities into the psychotherapeutic market in the coming years will profoundly alter the dynamics shaping access to and utilization of these products in much the same way the launch of the current generation of products changed the market within the last decade. It can be expected that these products will be launched with

Access and Utilization of New Antidepressant and Antipsychotic Medications. Chapter VIII. Future Directions in the Benefits Status of Psychotherapeutic Pharmaceuticals

The present study provides a single snapshot of a landscape that is rapidly changing. Numerous factors are affecting the structure of the health care payment system in the United States and the combination of these will likely result in a vastly different state of access to and utilization of pharmaceuticals in general and psychotherapeutics speci

Access and Utilization of New Antidepressant and Antipsychotic Medications. Pharmacoeconomic Analyses of Specific Antipsychotic Agents

We reviewed 38 studies that evaluate the pharmacoeconomics of newer antipsychotic medications to a relevant level of rigor. Only a small number of studies are prospective, randomized economic clinical trials conducted either in a naturalistic health care setting or as a "piggy back" to a clinical trial. Many of these studies are retrospective anal

Access and Utilization of New Antidepressant and Antipsychotic Medications. The Cost of Schizophrenia and Related Illness in the United States

Cost of illness studies on psychotic disorders in the U.S. reveal that patients with schizophrenia consume a disproportionate percentage of national healthcare dollars. It has been reported that although schizophrenia occurs in only 1% of the general population, patients with the disorder consume approximately 2.5% of total U.S. healthcare dollars

Access and Utilization of New Antidepressant and Antipsychotic Medications. C. The Cost-Effectiveness of Newer Antipsychotic Medications

Access and Utilization of New Antidepressant and Antipsychotic Medications. Pharmacoeconomic Analyses of Specific Pharmaceutical Agents

The Lewin Group identified 40 studies that evaluate the pharmacoeconomics of newer antidepressant medications to a reliable level of rigor. Twenty-nine studies compare newer antidepressants to older antidepressants; 11 studies compare newer antidepressants to other newer antidepressants. The majority of these studies are retrospective analyses of

Access and Utilization of New Antidepressant and Antipsychotic Medications. The Cost of Depressive Illness in the United States

Any understanding of the cost-effectiveness of a medical therapy must be based on both the cost of the illness being treated as well as the effectiveness of the therapy. Several cost of illness studies on depressive or affective disorders have been conducted in the US. One estimate placed the cost of affective disorders in 1990 at $30.4 billion, a

Access and Utilization of New Antidepressant and Antipsychotic Medications. B. The Cost-Effectiveness of Newer Antidepressant Medications

Access and Utilization of New Antidepressant and Antipsychotic Medications. A. Overview of Pharmacoeconomics

The term "cost-effectiveness" has been broadly applied to several methods of pharmacoeconomic analysis which compare the clinical and/or quality of life outcomes and costs associated with competing pharmacological agents. Measurements used in pharmacoeconomic analyses of the newer psychotropic therapies include cost-of-illness, cost-minimization,

Access and Utilization of New Antidepressant and Antipsychotic Medications. Chapter VII. Pharmacoeconomics of Newer Antidepressant and Antipsychotic Medications

As health care in the United States has become increasingly cost-conscious, providers are increasingly encouraged not only to consider the outcomes of treatment alternatives, but also to consider and justify costs. Similarly, payers have begun to examine the interaction of cost and effectiveness more carefully. The cost-effectiveness of newer anti

Access and Utilization of New Antidepressant and Antipsychotic Medications. E. Comparison of Psychotherapeutic Utilization with Utilization of Other Drug Classes

A primary concern of this study has been to determine whether newer psychotherapeutics are subject to more stringent utilization controls than are other classes of pharmaceuticals. In this section, we compare the utilization of psychotherapeutics with the utilization of other classes of pharmaceuticals that have seen the introduction of newer agen

Access and Utilization of New Antidepressant and Antipsychotic Medications. Patterns of Antidepressant Utilization in High-Volume States

Recognizing that national data may not be reflective of trends in individual States, utilization trends for 12 high-volume States (in number of prescriptions) in 1998 were analyzed in greater detail. The States included in this analysis are: California, Florida, Georgia, Illinois, Maryland, Massachusetts, Michigan, New Jersey, New York, Ohio, Penn

Access and Utilization of New Antidepressant and Antipsychotic Medications. In 1998, 62% of the 19 Million Medicaid Antidepressant Prescriptions were for New-Generation, Branded Antidepressants

Access and Utilization of New Antidepressant and Antipsychotic Medications. The Use of New-Generation Antidepressants in Medicaid Grew Dramatically Between 1995 and 1998

Exhibit VI-16 depicts national trends in prescriptions for antidepressants in Medicaid between 1995 and 1998. Overall, prescriptions for antidepressants increased substantially in this period. Antidepressant prescriptions increased from 13.7 million in 1995 to 19.3 million in 1998, an increase of over 40%. Exhibit VI-17 reports trends in Medica

Access and Utilization of New Antidepressant and Antipsychotic Medications. D. Utilization of Antidepressants in Medicaid, 1995-1998

The American Hospital Formulary lists over 30 different agents that are classified as antidepressants. Most of these belong to the general class of tricyclic antidepressants. For the purposes of this analysis, antidepressant medications were grouped into 12 general categories as indicated in Exhibit VI-12 below. Exhibit VI-12. Antidepressant Cl

Access and Utilization of New Antidepressant and Antipsychotic Medications. The Uptake of Newer Antipsychotic Agents into Medicaid Immediately Post-Launch has been Rapid

Two antipsychotic agents have been launched in the last two years: olanzapine in the 4 th quarter of 1996 and quetiapine in the 4 th quarter of 1997. The rates of uptake of each of these two drugs illustrate many of the factors that affect the rate of uptake of a new antipsychotic agent.

Access and Utilization of New Antidepressant and Antipsychotic Medications. Patterns of Antipsychotic Utilization in High-Volume States

Recognizing that national data may not be reflective of trends in individual States, utilization trends for 12 high-volume States (in number of prescriptions) in 1998 were analyzed in greater detail. The States included in this analysis were: California, Florida, Georgia, Illinois, Maryland, Massachusetts, Michigan, New Jersey, New York, Ohio, Pen

Access and Utilization of New Antidepressant and Antipsychotic Medications. The Use of Atypical Antipsychotics In Medicaid Has Grown Dramatically Since 1995

Exhibit VI-5 depicts national trends in prescriptions for antipsychotics in Medicaid between 1995 and 1998. Overall, antipsychotic prescriptions rose from 9.2 million in 1995 to 11 million in 1998, an increase of nearly 20%. At the same time, total expenditures increased from $484 million in 1995, to $894 million in 1997 and $1.3 billion in 1998,

Access and Utilization of New Antidepressant and Antipsychotic Medications. In 1998, 51% of All Medicaid Prescriptions for Antipsychotics were for Atypical Antipsychotics. Expenditures on Atypicals Accounted for 89% of Total Spending on Antipsychotics

Access and Utilization of New Antidepressant and Antipsychotic Medications. C. Utilization of Antipsychotics in Medicaid, 1995-1998

The American Hospital Formulary lists nearly twenty different agents that are classified as antipsychotics. Most of these belong to the general class of phenothiazine derivatives. For the purposes of this analysis, antipsychotic medications were grouped into 8 general categories as indicated in Exhibit VI-1 below.

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