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Medicaid spending and utilization for central nervous system drugs.

Baugh DK, Pine PL, Blackwell S, Ciborowski G - Health Care Financ Rev (2004)

Bottom Line: The analysis examines cost variation by census region, State, Medicaid basis of eligibility, and therapeutic use of drugs.In 1998, the highest expenditures were for central nervous system (CNS) drugs and for anti-psychotics compared to three other groups of CNS drugs (anti-anxiety agents, anti-depressants, and hypnotics).There were major variations among SMRF States and their respective regions.

View Article: PubMed Central - PubMed

Affiliation: Centers for Medicare & Medicaid Services (CMS), Baltimore, MD 21244-1850, USA. dbaugh@cms.hhs.gov

ABSTRACT
Prior research has shown that prescription drug spending grew substantially during the decade of the 1990s. This analysis uses 1996 to 1998 State Medicaid Research File (SMRF) fee-for-service (FFS) data for 29 participating States to provide insight into the factors driving this growth. The analysis examines cost variation by census region, State, Medicaid basis of eligibility, and therapeutic use of drugs. In 1998, the highest expenditures were for central nervous system (CNS) drugs and for anti-psychotics compared to three other groups of CNS drugs (anti-anxiety agents, anti-depressants, and hypnotics). By eligibility group, expenditures were typically highest for disabled enrollees. There were major variations among SMRF States and their respective regions.

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Medicaid Prescription Drug Payments for 29 SMRF States All Eligibles, by Drug Category: 1998Central Nervous System (CNS) Drug Payments Exceeded $1.5 Billion in the 29 SMRF StatesFor all four eligibility groups, CNS drug payments were over 48 percent greater than the second highest drug category, cardiovascular agents.Even though CNS drug payments exceeded payments for all other drug groups, the number of CNS prescriptions dispensed was not the highest. Prescriptions dispensed for cardiovascular agents outpaced CNS drugs 31.4 to 24.8 million.Medicaid payment per prescription for all eligibles in 1998 for these 29 States was highest, by an overwhelming margin, for biologicals at nearly $590 each (data not shown). Of the 17 drug groups, 15 averaged under $82 per perscription. In this comparison, CNS drug payments per prescription was comparable to most of the other groups and did not exhibit atypical cost averages.In 1998, the disabled eligibility group constituted a 55.3 percent share of the total Medicaid prescription drug payments (data not shown). The trend has shown yearly increases since at least 1990 when the disabled's share of drug payments was 42.2 percent of the total, an amount higher than any of the other three eligibility groups. This study highlights the increasingly important impact of the disabled on Medicaid payments and CNS drug use.
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f1-hcfr-26-1-057: Medicaid Prescription Drug Payments for 29 SMRF States All Eligibles, by Drug Category: 1998Central Nervous System (CNS) Drug Payments Exceeded $1.5 Billion in the 29 SMRF StatesFor all four eligibility groups, CNS drug payments were over 48 percent greater than the second highest drug category, cardiovascular agents.Even though CNS drug payments exceeded payments for all other drug groups, the number of CNS prescriptions dispensed was not the highest. Prescriptions dispensed for cardiovascular agents outpaced CNS drugs 31.4 to 24.8 million.Medicaid payment per prescription for all eligibles in 1998 for these 29 States was highest, by an overwhelming margin, for biologicals at nearly $590 each (data not shown). Of the 17 drug groups, 15 averaged under $82 per perscription. In this comparison, CNS drug payments per prescription was comparable to most of the other groups and did not exhibit atypical cost averages.In 1998, the disabled eligibility group constituted a 55.3 percent share of the total Medicaid prescription drug payments (data not shown). The trend has shown yearly increases since at least 1990 when the disabled's share of drug payments was 42.2 percent of the total, an amount higher than any of the other three eligibility groups. This study highlights the increasingly important impact of the disabled on Medicaid payments and CNS drug use.

Mentions: The data are presented for all of the Medi-Span therapeutic categories (Wolters Kluwer Health, 2003) in Figures 1 and 2. In Figures 3 through 11, data are presented by four of the Medi-Span therapeutic groups (anti-anxiety agents, anti-depressants, anti-psychotics, and hypnotics) within the CNS category. Additionally, data for individual SMRF States are presented within their respective regions in Figures 10 and 11. Tables 1 and 2 provide detailed information on CNS drug payments, number of prescriptions by State and basis of eligibility. Table 3 provides further detail on drug payments number of prescriptions, and drug recipients for the four CNS drug groups.


Medicaid spending and utilization for central nervous system drugs.

Baugh DK, Pine PL, Blackwell S, Ciborowski G - Health Care Financ Rev (2004)

Medicaid Prescription Drug Payments for 29 SMRF States All Eligibles, by Drug Category: 1998Central Nervous System (CNS) Drug Payments Exceeded $1.5 Billion in the 29 SMRF StatesFor all four eligibility groups, CNS drug payments were over 48 percent greater than the second highest drug category, cardiovascular agents.Even though CNS drug payments exceeded payments for all other drug groups, the number of CNS prescriptions dispensed was not the highest. Prescriptions dispensed for cardiovascular agents outpaced CNS drugs 31.4 to 24.8 million.Medicaid payment per prescription for all eligibles in 1998 for these 29 States was highest, by an overwhelming margin, for biologicals at nearly $590 each (data not shown). Of the 17 drug groups, 15 averaged under $82 per perscription. In this comparison, CNS drug payments per prescription was comparable to most of the other groups and did not exhibit atypical cost averages.In 1998, the disabled eligibility group constituted a 55.3 percent share of the total Medicaid prescription drug payments (data not shown). The trend has shown yearly increases since at least 1990 when the disabled's share of drug payments was 42.2 percent of the total, an amount higher than any of the other three eligibility groups. This study highlights the increasingly important impact of the disabled on Medicaid payments and CNS drug use.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4194875&req=5

f1-hcfr-26-1-057: Medicaid Prescription Drug Payments for 29 SMRF States All Eligibles, by Drug Category: 1998Central Nervous System (CNS) Drug Payments Exceeded $1.5 Billion in the 29 SMRF StatesFor all four eligibility groups, CNS drug payments were over 48 percent greater than the second highest drug category, cardiovascular agents.Even though CNS drug payments exceeded payments for all other drug groups, the number of CNS prescriptions dispensed was not the highest. Prescriptions dispensed for cardiovascular agents outpaced CNS drugs 31.4 to 24.8 million.Medicaid payment per prescription for all eligibles in 1998 for these 29 States was highest, by an overwhelming margin, for biologicals at nearly $590 each (data not shown). Of the 17 drug groups, 15 averaged under $82 per perscription. In this comparison, CNS drug payments per prescription was comparable to most of the other groups and did not exhibit atypical cost averages.In 1998, the disabled eligibility group constituted a 55.3 percent share of the total Medicaid prescription drug payments (data not shown). The trend has shown yearly increases since at least 1990 when the disabled's share of drug payments was 42.2 percent of the total, an amount higher than any of the other three eligibility groups. This study highlights the increasingly important impact of the disabled on Medicaid payments and CNS drug use.
Mentions: The data are presented for all of the Medi-Span therapeutic categories (Wolters Kluwer Health, 2003) in Figures 1 and 2. In Figures 3 through 11, data are presented by four of the Medi-Span therapeutic groups (anti-anxiety agents, anti-depressants, anti-psychotics, and hypnotics) within the CNS category. Additionally, data for individual SMRF States are presented within their respective regions in Figures 10 and 11. Tables 1 and 2 provide detailed information on CNS drug payments, number of prescriptions by State and basis of eligibility. Table 3 provides further detail on drug payments number of prescriptions, and drug recipients for the four CNS drug groups.

Bottom Line: The analysis examines cost variation by census region, State, Medicaid basis of eligibility, and therapeutic use of drugs.In 1998, the highest expenditures were for central nervous system (CNS) drugs and for anti-psychotics compared to three other groups of CNS drugs (anti-anxiety agents, anti-depressants, and hypnotics).There were major variations among SMRF States and their respective regions.

View Article: PubMed Central - PubMed

Affiliation: Centers for Medicare & Medicaid Services (CMS), Baltimore, MD 21244-1850, USA. dbaugh@cms.hhs.gov

ABSTRACT
Prior research has shown that prescription drug spending grew substantially during the decade of the 1990s. This analysis uses 1996 to 1998 State Medicaid Research File (SMRF) fee-for-service (FFS) data for 29 participating States to provide insight into the factors driving this growth. The analysis examines cost variation by census region, State, Medicaid basis of eligibility, and therapeutic use of drugs. In 1998, the highest expenditures were for central nervous system (CNS) drugs and for anti-psychotics compared to three other groups of CNS drugs (anti-anxiety agents, anti-depressants, and hypnotics). By eligibility group, expenditures were typically highest for disabled enrollees. There were major variations among SMRF States and their respective regions.

Show MeSH