Medicaid Prior Authorization Policies for Pediatric Use of Antipsychotic Medications

Schmid, Ian; Burcu, Mehmet; Zito, Julie Magno

doi:10.1001/jama.2015.0763

Cited by 37 publications

(47 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…: [40, 41] have appeared. In the US, awareness programs targeting clinicians and the public were developed [42] and a system for prior authorization of antipsychotic prescribing for Medicaid insured youth [43] is implemented in 31 states.…”

Section: Discussionmentioning

confidence: 99%

A multi-national comparison of antipsychotic drug use in children and adolescents, 2005–2012

Kalverdijk

Bachmann

Aagaard³

et al. 2017

Child Adolesc Psychiatry Ment Health

Self Cite

View full text Add to dashboard Cite

Over the last decades, an increase in antipsychotic (AP) prescribing and a shift from first-generation antipsychotics (FGA) to second-generation antipsychotics (SGA) among youth have been reported. However, most AP prescriptions for youth are off-label, and there are worrying long-term safety data in youth. The objective of this study was to assess multinational trends in AP use among children and adolescents. A repeated cross-sectional design was applied to cohorts from varied sources from Denmark, Germany, the Netherlands, the United Kingdom (UK) and the United States (US) for calendar years 2005/2006–2012. The annual prevalence of AP use was assessed, stratified by age group, sex and subclass (FGA/SGA). The prevalence of AP use increased from 0.78 to 1.03% in the Netherlands’ data, from 0.26 to 0.48% in the Danish cohort, from 0.23 to 0.32% in the German cohort, and from 0.1 to 0.14% in the UK cohort. In the US cohort, AP use decreased from 0.94 to 0.79%. In the US cohort, nearly all ATP dispensings were for SGA, while among the European cohorts the proportion of SGA dispensings grew to nearly 75% of all AP dispensings. With the exception of the Netherlands, AP use prevalence was highest in 15–19 year-olds. So, from 2005/6 to 2012, AP use prevalence increased in all youth cohorts from European countries and decreased in the US cohort. SGA were favoured in all countries’ cohorts.

show abstract

Section: Discussionmentioning

confidence: 99%

A multi-national comparison of antipsychotic drug use in children and adolescents, 2005–2012

Kalverdijk

Bachmann

Aagaard³

et al. 2017

Child Adolesc Psychiatry Ment Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…; Child and Family Service Improvement and Innovation Act). Thirty‐one states have chosen to implement (mostly within the past 5 years) Medicaid prior authorization policies for pediatric use of atypical antipsychotic medications (Schmid, Burcu, and Zito ). Despite the intuitive care system value that both consultation to primary care and prescription oversight/second opinion review programs may offer, the data‐based impacts of these services for children have not been well studied.…”

mentioning

confidence: 99%

Decrease in Statewide Antipsychotic Prescribing after Implementation of Child and Adolescent Psychiatry Consultation Services

Barclay

Penfold

Sullivan

et al. 2017

Health Services Research

View full text Add to dashboard Cite

show abstract

“…A number of strategies, including prior authorization and step therapy requirements, 39–44 tiered formularies, 45,46 monitoring and feedback (e.g., computerized alerts, reminders, audit and feedback), 47 academic detailing, 48,49 and policies restricting detailing efforts by pharmaceutical manufacturers 50 have proven effective at influencing physician prescribing behavior in general. Payers and health plans could consider applying these approaches to antipsychotic prescribing to young children in an effort to highlight for prescribers the risk-benefit tradeoffs associated with antipsychotic use in children.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Antipsychotic Prescribing by Physicians to Young Children

Huskamp¹,

Horvitz-Lennon²,

Berndt³

et al. 2016

View full text Add to dashboard Cite

Objective Antipsychotic medication use has grown rapidly among young children despite the lack of Food and Drug Administration approval for antipsychotics' broad use in this age group. Characteristics of physicians who prescribe antipsychotics to young children were identified, and prescribing patterns were compared for young children and adults. Methods Physician-level prescribing data from IMS Health's Xponent™ database linked with American Medical Association Masterfile data were analyzed. Sample included all U.S. psychiatrists plus a 5% random sample of family medicine physicians who wrote at least ten antipsychotic prescriptions per year from 2008-2011 (n=31,713). Logistic and hierarchical binomial regression models were estimated to examine physician prescribing for young children 0-9, and the types and numbers of ingredients used for young children vs. adults 20-64 were examined. Results Among antipsychotic prescribers, 42.2% had ≥1 prescriptions for young children. Such prescribing was more likely among younger physicians (e.g., OR=1.70; CI=1.54-1.89 for ≤39 vs. 60+), and those practicing in rural areas (OR=1.11; CI=1.02-1.21), and less likely among males (OR=.93; CI-.88-.98) and those who graduated from a top 25 U.S. medical school (OR=.87; CI=.81-.94). Among physicians who prescribed to both young children and adults, 75.0% of young child prescriptions were for drugs with an FDA-approved indication for this age range (vs. 35.7% of adult prescriptions), and a much smaller number of ingredients were used on average for young child vs. adult patients (median=2 vs. 7). Conclusions While prescribing for young children is relatively common across antipsychotic prescribers, prescribing patterns differ for young children relative to adults.

show abstract

Medicaid Prior Authorization Policies for Pediatric Use of Antipsychotic Medications

Cited by 37 publications

References 4 publications

A multi-national comparison of antipsychotic drug use in children and adolescents, 2005–2012

A multi-national comparison of antipsychotic drug use in children and adolescents, 2005–2012

Decrease in Statewide Antipsychotic Prescribing after Implementation of Child and Adolescent Psychiatry Consultation Services

Patterns of Antipsychotic Prescribing by Physicians to Young Children

Contact Info

Product

Resources

About