+ 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

Medication continuity among Medicaid beneficiaries with schizophrenia and bipolar disorder

Medication continuity among Medicaid beneficiaries with schizophrenia and bipolar disorder

Psychiatric Services 64(9): 878-885

This study was conducted to examine whether medication continuity among Medicaid beneficiaries with schizophrenia and bipolar disorder was associated with medication utilization management practices (prior authorization, copayment amounts, and refill and pill quantity limits), managed care enrollment, and other state and beneficiary characteristics. With 2007 Medicaid Analytic Extract claims data from 22 states, random-effects logistic regression modeled the odds of high medication continuity, defined as receiving medications for at least 80% of the days enrolled in Medicaid, among beneficiaries ages 18-64 with a diagnosis of schizophrenia (N=91,451) or bipolar disorder (N=33,234). Sixty-four percent of beneficiaries with schizophrenia and 54% of beneficiaries with bipolar disorder had high medication continuity. Medication continuity was worse among beneficiaries with schizophrenia in states that required prior authorization for antipsychotics, $2-$3 copayments for generic medications, or $1 copayments for branded medications (compared with no copayments). For beneficiaries with bipolar disorder, medication continuity was worse among those in states with more prior-authorization requirements for different classes of medications or $1 copayments for branded medications. Medication continuity was worse among beneficiaries who were African American, Hispanic, younger, or enrolled in a health maintenance organization health plan or who had a comorbid substance use disorder or cardiovascular disease. Prior-authorization requirements and copayments for medications may present barriers to refilling medications for Medicaid beneficiaries with schizophrenia or bipolar disorder. State Medicaid programs should consider the unintended consequences of medication utilization management practices for this population.

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

Accession: 054313857

Download citation: RISBibTeXText

PMID: 23728475

DOI: 10.1176/appi.ps.201200349

Related references

Effects of prior authorization on medication discontinuation among Medicaid beneficiaries with bipolar disorder. Psychiatric Services 60(4): 520-527, 2009

State Variation in the Delivery of Comprehensive Services for Medicaid Beneficiaries with Schizophrenia and Bipolar Disorder. Community Mental Health Journal 51(5): 523-534, 2016

Adherence to treatment with antipsychotic medication and health care costs among Medicaid beneficiaries with schizophrenia. American Journal of Psychiatry 161(4): 692-699, 2004

Continuity of antipsychotic medication management for Medicaid patients with schizophrenia. Psychiatric Services 62(7): 747-752, 2011

Comparison of second-generation antipsychotic treatment on psychiatric hospitalization in Medicaid beneficiaries with bipolar disorder. Journal of Medical Economics 14(6): 777-786, 2012

Trends in use of antipsychotics and mood stabilizers among Medicaid beneficiaries with bipolar disorder, 2001-2004. Psychiatric Services 59(10): 1169-1174, 2008

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

Assisting Social Security Disability Insurance beneficiaries with schizophrenia, bipolar disorder, or major depression in returning to work. American Journal of Psychiatry 170(12): 1433-1441, 2014

Predictors of medication nonadherence and hospitalization in Medicaid patients with bipolar I disorder given long-acting or oral antipsychotics. Journal of Medical Economics 14(2): 217-226, 2011

Toward convergence in the medication treatment of bipolar disorder and schizophrenia. Harvard Review of Psychiatry 13(1): 28-42, 2005

Formulary restrictions on atypical antipsychotics: impact on costs for patients with schizophrenia and bipolar disorder in Medicaid. American Journal of Managed Care 20(2): E52-E60, 2015

Predictors of medication adherence in patients with schizophrenia and bipolar disorder. Acta Psychiatrica Scandinavica 127(1): 23-33, 2013

Negative, psychoticism, and disorganized dimensions in patients with familial schizophrenia or bipolar disorder: continuity and discontinuity between the major psychoses. American Journal of Psychiatry 152(10): 1458-1463, 1995

Treatment of bipolar disorder with antipsychotic medication: issues shared with schizophrenia. Journal of Clinical Psychiatry 68 Suppl 6: 24-25, 2007

Mitochondrial Complex I Deficiency in Schizophrenia and Bipolar Disorder and Medication Influence. Molecular Neuropsychiatry 3(3): 157-169, 2018