+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Adherence to treatment with antipsychotic medication and health care costs among Medicaid beneficiaries with schizophrenia

Adherence to treatment with antipsychotic medication and health care costs among Medicaid beneficiaries with schizophrenia

American Journal of Psychiatry 161(4): 692-699

Objective: The authors' goal was to evaluate the relationship between adherence to treatment with antipsychotic medication and health expenditures. A secondary objective was to identify risk factors predictive of nonadherence. Method: Data included Medicaid eligibility and claims data from 1998 to 2000 for San Diego County, Calif. Pharmacy records were used to assess adherence to treatment with antipsychotic medication according to the cumulative possession ratio (the number of days medications were available for consumption divided by the number of days subjects were eligible for Medi-Cal). Regression models were used to examine risk factors, hospitalizations, and costs associated with nonadherence, partial adherence, adherence, and excess fills of antipsychotic medication. Results: Forty-one percent of Medicaid beneficiaries with schizophrenia were found to be adherent to treatment with their antipsychotic medications: 24% were nonadherent, 16% were partially adherent, and 19% were excess fillers. Rates of psychiatric hospitalization were lower for those who were adherent (14%) than for those who were nonadherent (35%), partially adherent (24%), or had excess fills (25%). Rates of medical hospitalization were lower for those who were adherent (7%) than for those who were nonadherent (13%) or had excess fills (12%). Those who were adherent had significantly lower hospital costs than the other groups; pharmacy costs were higher among those who were adherent than among those who were nonadherent or partially adherent and were highest for excess fillers. Total costs for excess fillers (dollar sign14,044) were substantially higher than total costs for any other group. Conclusions: Despite the widespread use of atypical antipsychotic medications, alarmingly high rates of both underuse and excessive filling of antipsychotic prescriptions were found in Medicaid beneficiaries with schizophrenia. The high rates of antipsychotic nonadherence and associated negative consequences suggest interventions on multiple levels.

(PDF emailed within 0-6 h: $19.90)

Accession: 011731046

Download citation: RISBibTeXText

PMID: 15056516

DOI: 10.1176/appi.ajp.161.4.692

Related references

The relationship of antipsychotic medication class and adherence with treatment outcomes and costs for Florida Medicaid beneficiaries with schizophrenia. Administration and Policy in Mental Health 34(3): 307-314, 2007

Health care resource utilization and costs of California Medicaid patients with schizophrenia treated with paliperidone palmitate once monthly or atypical oral antipsychotic treatment. Current Medical Research and Opinion 33(4): 723-731, 2017

Antipsychotic adherence, switching, and health care service utilization among Medicaid recipients with schizophrenia. Patient Preference and Adherence 4(): 263-271, 2010

Medicaid beneficiaries with congestive heart failure: association of medication adherence with healthcare use and costs. American Journal of Managed Care 15(7): 437-445, 2010

Antiretroviral therapy adherence, medication use, and health care costs during 3 years of a community pharmacy medication therapy management program for Medi-Cal beneficiaries with HIV/AIDS. Journal of Managed Care Pharmacy 17(3): 213-223, 2011

Medication adherence and health care costs associated with biologics in Medicaid-enrolled patients with psoriasis. Journal of Dermatological Treatment 17(5): 294-301, 2006

Adherence, Healthcare Resource Utilization, and Costs in Medicaid Beneficiaries with Schizophrenia Transitioning from Once-Monthly to Once-Every-3-Months Paliperidone Palmitate. Pharmacoeconomics - Open, 2018

Prospective Service Use and Health Care Costs of Medicaid Beneficiaries with Treatment-Resistant Depression. Journal of Managed Care & Specialty Pharmacy 24(3): 226-236, 2018

Antipsychotic adherence patterns and health care utilization and costs among patients discharged after a schizophrenia-related hospitalization. Bmc Psychiatry 13(): 246-246, 2014

A Medicaid and commercial insured claims-based study to estimate improved antipsychotic medication adherence among patients with schizophrenia. Journal of Behavioral Health Services & Research 40(2): 222-233, 2014

Medication costs, adherence, and health outcomes among Medicare beneficiaries. Health Affairs 22(4): 220-229, 2003

Health care costs and medication adherence associated with initiation of insulin pen therapy in medicaid-enrolled patients with type 2 diabetes: a retrospective database analysis. Clinical Therapeutics 29 Spec No(): 1294-1305, 2007

The impact of non-adherence to medication in patients with schizophrenia on health, social care and societal costs. Analysis of the QUATRO study. Epidemiology and Psychiatric Sciences 23(1): 61-70, 2013

Antipsychotic medication use patterns and associated costs of care for individuals with schizophrenia. Journal of Mental Health Policy and Economics 6(2): 67-75, 2003

A randomized controlled trial of intensive care management for disabled Medicaid beneficiaries with high health care costs. Health Services Research 50(3): 663-689, 2015