The effects of prior authorization policies on medicaid-enrolled children's use of antipsychotic medications: Evidence from two mid-Atlantic states

Journal of Child and Adolescent Psychopharmacology

Volumn 24, Issue 7, 2014, Pages 374-381

  Stein, Bradley D ^a,b   Leckman Westin, Emily ^c,d   Okeke, Edward ^g   Scharf, Deborah M ^a,b   Sorbero, Mark ^a   Chen, Qingxian ^c   Chor, Ka Ho Brian ^e   Finnerty, Molly ^c,e   Wisdom, Jennifer P ^f  

^a RAND CORPORATION   (United States)

^b UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE   (United States)

^c NEW YORK STATE OFFICE OF MENTAL HEALTH   (United States)

^d UNIVERSITY AT ALBANY   (United States)

^e NEW YORK UNIVERSITY SCHOOL OF MEDICINE   (United States)

^f GEORGE WASHINGTON UNIVERSITY   (United States)

^g NONE

Author keywords

[No Author keywords available]

Indexed keywords

ANTIDEPRESSANT AGENT; NEUROLEPTIC AGENT;

ADOLESCENT; ARTICLE; CHILD; CHILD CARE; DRUG UTILIZATION; HEALTH CARE POLICY; HEALTH SERVICE; HUMAN; INFANT; MAJOR CLINICAL STUDY; MEDICAID; NEWBORN; PRESCRIPTION; PRIOR AUTHORIZATION POLICY; UNITED STATES; AGE; FEMALE; HEALTH INSURANCE; MALE; POLICY; PRESCHOOL CHILD; TRENDS;

ADOLESCENT; AGE FACTORS; ANTIDEPRESSIVE AGENTS; ANTIPSYCHOTIC AGENTS; CHILD; CHILD, PRESCHOOL; FEMALE; HUMANS; INFANT; INSURANCE, PHARMACEUTICAL SERVICES; MALE; MEDICAID; MID-ATLANTIC REGION; POLICY; UNITED STATES;

EID: 84907033258     PISSN: 10445463     EISSN: 15578992     Source Type: Journal    
DOI: 10.1089/cap.2014.0008     Document Type: Article

References (64)

1. Abouzaid S, Jutkowitz E, Foley KA, Pizzi LT, Kim E, Bates J: Economic impact of prior authorization policies for atypical anti- psychotics in the treatment of schizophrenia. Popul Health Manag 13:247-254, 2010.
2. Adams AS, Zhang F, LeCates RF, Graves AJ, Ross-Degnan D, Gilden D, McLaughlin TJ, Lu C, Trinacty CM, Soumerai SB: Prior authorization for antidepressants in Medicaid: Effects among disabled dual enrollees. Arch Intern Med 169:750, 2009.
3. Aparasu RR, Bhatara V: Patterns and determinants of antipsychotic prescribing in children and adolescents, 2003-2004. Curr Med Res Opin 23:49-56, 2007.
4. Becker ER, Constantine RJ, McPherson MA, Jones ME: Antipsychotic polypharmacy prescribing patterns and costs in the Florida adult and child Medicaid populations. J Health Care Finance 40:40-67, 2013.
5. Berndt ER, Donohue JM: The economics of advertising in health care markets. In: Incentives and Choice in Health Care. Edited by F. Sloan and H. Kasper. Cambridge, MA: MIT Press; 2008. pp 131-162.
6. Caccavale J: Psychiatry In Crisis: Impacts on Primary Care, Patient Safety and Public Healthcare Policy. I. Available at http:// www.truthindrugs.org/pdf/crisis.pdf. Accessed May 21, 2014.
7. Constantine R, Tandon R: Changing trends in pediatric antipsychotic use in Florida's Medicaid program. Psychiatr Serv 59:1162-1168, 2008.
8. Constantine RJ, Tandon R, McPherson M, Andel R: Early diagnoses and psychotherapeutic medication treatment experiences of a cohort of children under 6 years old who received antipsychotic treatment in Florida's Medicaid program. J Child Adolesc Psychopharmacol 21:79-84, 2011.
9. Cooper WO, Arbogast PG, Ding H, Hickson GB, Fuchs DC, Ray WA: Trends in prescribing of antipsychotic medications for US children. Ambul Pediatr 6:79-83, 2006.
10. Correll CU: Weight gain and metabolic effects of mood stabilizers and antipsychotics in pediatric bipolar disorder: A systematic review and pooled analysis of short-term trials. J Am Acad Child Adolesc Psychiatry 46:687, 2007.
11. Correll CU, Carlson HE: Endocrine and metabolic adverse effects of psychotropic medications in children and adolescents. J Am Acad Child Adolesc Psychiatry 45:771-791, 2006.
12. Correll CU, Manu P, Olshanskiy V, Napolitano B, Kane JM, Malhotra AK: Cardiometabolic risk of second-generation antipsychotic medications during first-time use in children and adolescents. JAMA 302:1765-1773, 2009.
13. Crystal S, Olfson M, Huang C, Pincus H, Gerhard T: Broadened use of atypical antipsychotics: safety, effectiveness, and policy challenges. Health Aff (Millwood) 28:w770-781, 2009.
14. Cunningham PJ: Beyond parity: Primary care physicians' perspectives on access to mental health care. Health Aff (Millwood) 28:w490-501, 2009.
15. Cunningham PJ: Medicaid cost containment and access to prescription drugs. Health Aff (Millwood) 24:780-789, 2005.
16. Domino ME, Swartz MS: Who are the new users of antipsychotic medications? Psychiatr Serv 59:507-514, 2008.
17. Farley JF, Cline RR, Schommer JC, Hadsall RS, Nyman JA: Retrospective assessment of Medicaid step-therapy prior authorization policy for atypical antipsychotic medications. Clin Ther 30:1524-1539, 2008.
18. Findling RL: Atypical antipsychotic treatment of disruptive behavior disorders in children and adolescents. J Clin Psychiatry 69 Suppl 4:9-14, 2008.
19. Fischer MA, Servi AD, Polinski JM, Wang PS: Restrictions on antidepressant medications for children: A review of Medicaid policy. Psychiatr Serv 58:135-138, 2007.
20. Foti ME, Harper G, Moon R, Oestreich G, Snow R, Thompson J, Finnerty M, Freeman E, Knapp P, Muse NJ, Parks J, Crystal S, Gerhard T, Wilson N: Antipsychotic Medication Use in Medicaid Children and Adolescents: Report and Resource Guide From a 16-State Study. MMDLN/Rutgers CERTs, 2010.
21. Hammerman A, Dreiher J, Klang SH, Munitz H, Cohen AD, Goldfracht M: Antipsychotics and diabetes: An age-related association. Ann Pharmacother 42:1316-1322, 2008.
22. Hilt RJ: Monitoring psychiatric medications in children. Pediatr Ann 41:157-163, 2012.
23. Hilt R, McDonell MG RC, Golombek A, Thompson J: The Partnership Access Line: Establishing an empirically based child psychiatry consultation program for Washington State. Rep Emot Behav Disord Youth 9:9-12, 2009.
24. Hilt RJ, Romaire MA, McDonell MG, Sears JM, Krupski A, Thompson JN, Myers J, Trupin EW: The Partnership Access Line: Evaluating a child psychiatry consult program in Washington State. JAMA Pediatr 167:162-168, 2013.
25. Hilt R, Varley C, Thompson J: Antipsychotic utilization changes for Medicaid children associated with Washington state PAL and 2nd opinion telephone mental health consult services. Neuropsychiatr Enfance et Adolesc 60:S185-S186, 2012.
26. Horwitz SM, Kelleher KJ, Stein RE, Storfer-Isser A, Youngstrom EA, Park ER, Heneghan AM, Jensen PS, O'Connor KG, Hoagwood KE: Barriers to the identification and management of psychosocial issues in children and maternal depression. Pediatrics 119:e208-218, 2007.
27. Jerrell JM, McIntyre RS, Black GB: Economic grand rounds: economic costs of failure to monitor adverse effects of secondgeneration antipsychotics: An underestimated factor. Psychiatr Serv 63:202-204, 2012.
28. Kim WJ: Child and adolescent psychiatry workforce: A critical shortage and national challenge. Acad Psychiatry 27:277-282, 2003.
29. Koplewicz H. Answers About Child Psychiatry.The New York Times, May 26, 2010.
30. Law MR, Ross-Degnan D, Soumerai SB: Effect of prior authorization of second-generation antipsychotic agents on pharmacy utilization and reimbursements. Psychiatr Serv 59:540-546, 2008.
31. Leslie LK, Raghavan R, Hurley M, Zhang J, Landsverk J, Aarons G: Investigating geographic variation in use of psychotropic medications among youth in child welfare. Child Abuse Negl 35:333-342, 2011.
32. Loy J, Merry S, Hetrick S, Stasiak K: Atypical antipsychotics for disruptive behaviour disorders in children and youths. Cochrane Database Syst Rev 9:CD008559, 2012.
33. Manderscheid RW, Henderson MJ: Mental health practitioners and trainees. In: Mental Health, United States, 2002. Rockville, MD: United States Department of Health and Human Services (USDHHS), Substance Abuse and Mental Health Services Administration; 2002, pp. 332-373.
34. Matone M, Localio R, Huang YS, Dosreis S, Feudtner C, Rubin D: The relationship between mental health diagnosis and treatment with second-generation antipsychotics over time: A national study of U.S. Medicaid-enrolled children. Health Serv Res 47:1836-1860, 2012.
35. McIntyre RS, Jerrell JM: Metabolic and cardiovascular adverse events associated with antipsychotic treatment in children and adolescents. Arch Pediatr Adolesc Med 162:929-935, 2008.
36. Merikangas KR, He J, Rapoport J, Vitiello B, Olfson M: Medication use in US youth with mental disorders. Arch Pediatr Adolesc Med:1-8, 2012.
37. Musgrove B. Use of antipsychotic drugs up sharply among poor children in Kentucky. I. Available at http://www.mcclatchydc.com/ 2012/10/10/171084/use-of-antipsychotic-drugs-up.html Accessed May 21, 2014.
38. Naylor M: Monitoring the use of antipsychotic medications in foster children: The Illinois model. In: Proceedings of the 60th Annual Meeting of the American Academy of Child and Adolescent Psychiatry. Orlando, FL, 2013.
39. Naylor MW, Davidson CV, Ortega-Piron DJ, Bass A, Gutierrez A, Hall A: Psychotropic medication management for youth in state care: Consent, oversight, and policy considerations. Child Welfare 86:175-192, 2007.
40. Olfson M, Blanco C, Liu SM, Wang S, Correll CU: National trends in the office-based treatment of children, adolescents, and adults with antipsychotics. Arch Gen Psychiatry 69:1247-1256, 2012.
41. Olfson M, Blanco C, Liu L, Moreno C, Laje G: National trends in the outpatient treatment of children and adolescents with antipsychotic drugs. Arch Gen Psychiatry 63:679-685, 2006.
42. Olfson M, Crystal S, Huang C, Gerhard T: Trends in antipsychotic drug use by very young, privately insured children. J Am Acad Child Adolesc Psychiatry 49:13-23, 2010.
43. Olfson M, Marcus SC, Weissman MM, Jensen PS: National trends in the use of psychotropic medications by children. J Am Acad Child Adolesc Psychiatry 41:514-521, 2002.
44. Pappadopulos E, Jensen PS, Schur SB, MacIntyre JC, 2nd, Ketner S, Van Orden K, Sverd J, Sardana S, Woodlock D, Schweitzer R, Rube D: "Real world" atypical antipsychotic prescribing practices in public child and adolescent inpatient settings. Schizophr Bull 28:111-121, 2002.
45. Patel NC, Crismon ML, Hoagwood K, Johnsrud MT, Rascati KL, Wilson JP: Physician specialty associated with antipsychotic prescribing for youths in the Texas Medicaid program. Med Care 44:87-90, 2006.
46. Patel NC, Crismon ML, Hoagwood K, Johnsrud MT, Rascati KL, Wilson JP, Jensen PS: Trends in the use of typical and atypical antipsychotics in children and adolescents. J Am Acad Child Adolesc Psychiatry 44:548-556, 2005.
47. Patel NC, Sanchez RJ, Johnsrud MT, Crismon ML: Trends in antipsychotic use in a Texas medicaid population of children and adolescents: 1996 to 2000. J Child Adolesc Psychopharmacol 12:221-229, 2002.
48. Pathak P, West D, Martin BC, Helm ME, Henderson C: Evidencebased use of second-generation antipsychotics in a state Medicaid pediatric population, 2001-2005. Psychiatr Serv 61:123-129, 2010.
49. Pathak S, Arszman SP, Danielyan A, Johns ES, Smirnov A, Kowatch RA: Psychotropic utilization and psychiatric presentation of hospitalized very young children. J Child Adolesc Psychopharmacol 14:433-442, 2004.
50. Raghavan R, Lama G, Kohl P, Hamilton B: Interstate variations in psychotropic medication use among a national sample of children in the child welfare system. Child Maltreat 15:121-131, 2010.
51. Rubin D: Conflicting data on psychotropic use by children: Two pieces to the same puzzle. JAMA Pediatr 126, 189-190, 2013.
52. Seida J, Schouten J, Mousavi S, Hamm M, Beaith A, Vandermeer B, Dryden D, Boylan K, Newton A: First-and second-generation antipsychotics for children and young adults. Comparative Effectiveness Review No. 39. Rockville, MD: Agency for Healthcare Research and Quality; 2012.
53. Simeone JC, Marcoux RM, Quilliam BJ: Cost and utilization of behavioral health medications associated with rescission of an exemption for prior authorization for severe and persistent mental illness in the Vermont Medicaid program. J Manag Care Pharm 16:317-328, 2010.
54. Soumerai SB, Zhang F, Ross-Degnan D, Ball DE, LeCates RF, Law MR, Hughes TE, Chapman D, Adams AS: Use of atypical antipsychotic drugs for schizophrenia in Maine Medicaid following a policy change. Health Aff (Millwood) 27:w185-195, 2008.
55. Texas Health and Human Services Commission: Safety and Appropriateness of Antipsychotic Medications for Medicaid Children Under Age 16. Report to the Texas Legislature as Required by H.B. 2163, 81st Legislature, Regular Session, 2009, 2010.
56. Thomas CP, Conrad P, Casler R, Goodman E: Trends in the use of psychotropic medications among adolescents, 1994 to 2001. Psychiatr Serv 57:63-69, 2006.
57. Thomas CR, Holzer CE, 3rd: The continuing shortage of child and adolescent psychiatrists. J Am Acad Child Adolesc Psychiatry 45:1023-1031, 2006.
58. Vogt WB, Joyce G, Xia J, Dirani R, Wan G, Goldman DP: Medicaid cost control measures aimed at second-generation antipsychotics led to less use of all antipsychotics. Health Aff (Millwood) 30:2346-2354, 2011.
59. Walthour A, Seymour L, Tackett R, Perri M: Assessment of changes in utilization of health-care services after implementation of a prior authorization policy for atypical antipsychotic agents. Ann Pharmacother 44:809-818, 2010.
60. Wolraich ML: Annotation: The use of psychotropic medications in children: An American view. J Child Psychol Psychiatry 44:159-168, 2003.
61. Zito J, Safer D, de Jong-van den Berg LT, Janhsen K, Fegert JM, Gardner JF, Glaeske G, Valluri SC.: A three-country comparison of psychotropic medication prevalence in youth. Child Adolesc Psychiatry Ment Health 2:26-33, 2008a.
62. Zito JM, Safer DJ, dosReis S, Gardner JF, Boles M, Lynch F: Trends in the prescribing of psychotropic medications to preschoolers. JAMA 283:1025-1030, 2000.
63. Zito JM, Safer DJ, DosReis S, Gardner JF, Magder L, Soeken K, Boles M, Lynch F, Riddle MA: Psychotropic practice patterns for youth: A 10-year perspective. Arch Pediatr Adolesc Med 157:17-25, 2003.
64. Zito JM, Safer DJ, Sai D, Gardner JF, Thomas D, Coombes P, Dubowski M, Mendez-Lewis M: Psychotropic medication patterns among youth in foster care. Pediatrics 121:e157-163, 2008b.