Health Affairs

Health Affairs, 27, no. 3 (2008): w185-w195 (Published online 1 April 2008) doi: 10.1377/hlthaff.27.3.w185 © 2008 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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Use Of Atypical Antipsychotic Drugs For Schizophrenia In Maine Medicaid Following A Policy Change

Stephen B. Soumerai, Fang Zhang, Dennis Ross-Degnan, Daniel E. Ball, Robert F. LeCates, Michael R. Law, Tom E. Hughes, Daniel Chapman and Alyce S. Adams

More than one-third of Medicaid programs and Medicare Part D plans use prior authorization (PA) policies to control the use of atypical antipsychotics (AAs). We used Medicaid and Medicare claims data to investigate how Maine’s PA policy affected AA use, treatment discontinuities, and spending among schizophrenia patients initiating AA therapy. Patients initiating AAs during Maine’s policy experienced a 29 percent greater risk of treatment discontinuity than patients initiating AAs before the policy took effect; no change occurred in a comparison state. AA spending was slightly lower in both states. Observed increases in treatment discontinuities without cost savings suggest that AAs should be exempt from PA for patients with severe mental illnesses.

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