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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 Central Nervous System (CNS) Drug Payments for 29 SMRF States, by Basis of Eligibility: 1996-1998In the 29 SMRF States, the Disabled had the Largest Share of CNS Drug PaymentsThe disabled had $658 million in CNS drug payments in 1996, $840 million in 1997, and $1,102 million in 1998. The disabled had the largest share of CNS drug payments for all 3 years.The largest change in share was a modest increase for the disabled which experienced an increase from 71.4 percent of the total spending for CNS drugs in 1996 to 72.9 percent in 1998.From 1996 to 1998 there was virtually no shift in the share of payments for CNS prescription drugs based on eligibility. The aged received about 19 percent, the disabled received about 72 percent, adults received about 5.5 percent and children received only 3.2 percent.By no means should these seemingly mild changes in spending shares indicate that CNS drug spending is under control. The unchanging nature of the share of payments may actually be a concern for the Medicaid Program since payments for these years may serve as indicators that high CNS payments could burden Medicaid for the foreseeable future. The breakdown of payments by basis of eligibility for these 3 years merely indicates how CNS drug payments have been channeled to these 4 segments of the population.
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f3-hcfr-26-1-057: Medicaid Central Nervous System (CNS) Drug Payments for 29 SMRF States, by Basis of Eligibility: 1996-1998In the 29 SMRF States, the Disabled had the Largest Share of CNS Drug PaymentsThe disabled had $658 million in CNS drug payments in 1996, $840 million in 1997, and $1,102 million in 1998. The disabled had the largest share of CNS drug payments for all 3 years.The largest change in share was a modest increase for the disabled which experienced an increase from 71.4 percent of the total spending for CNS drugs in 1996 to 72.9 percent in 1998.From 1996 to 1998 there was virtually no shift in the share of payments for CNS prescription drugs based on eligibility. The aged received about 19 percent, the disabled received about 72 percent, adults received about 5.5 percent and children received only 3.2 percent.By no means should these seemingly mild changes in spending shares indicate that CNS drug spending is under control. The unchanging nature of the share of payments may actually be a concern for the Medicaid Program since payments for these years may serve as indicators that high CNS payments could burden Medicaid for the foreseeable future. The breakdown of payments by basis of eligibility for these 3 years merely indicates how CNS drug payments have been channeled to these 4 segments of the population.

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 Central Nervous System (CNS) Drug Payments for 29 SMRF States, by Basis of Eligibility: 1996-1998In the 29 SMRF States, the Disabled had the Largest Share of CNS Drug PaymentsThe disabled had $658 million in CNS drug payments in 1996, $840 million in 1997, and $1,102 million in 1998. The disabled had the largest share of CNS drug payments for all 3 years.The largest change in share was a modest increase for the disabled which experienced an increase from 71.4 percent of the total spending for CNS drugs in 1996 to 72.9 percent in 1998.From 1996 to 1998 there was virtually no shift in the share of payments for CNS prescription drugs based on eligibility. The aged received about 19 percent, the disabled received about 72 percent, adults received about 5.5 percent and children received only 3.2 percent.By no means should these seemingly mild changes in spending shares indicate that CNS drug spending is under control. The unchanging nature of the share of payments may actually be a concern for the Medicaid Program since payments for these years may serve as indicators that high CNS payments could burden Medicaid for the foreseeable future. The breakdown of payments by basis of eligibility for these 3 years merely indicates how CNS drug payments have been channeled to these 4 segments of the population.
© Copyright Policy
Related In: Results  -  Collection

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

f3-hcfr-26-1-057: Medicaid Central Nervous System (CNS) Drug Payments for 29 SMRF States, by Basis of Eligibility: 1996-1998In the 29 SMRF States, the Disabled had the Largest Share of CNS Drug PaymentsThe disabled had $658 million in CNS drug payments in 1996, $840 million in 1997, and $1,102 million in 1998. The disabled had the largest share of CNS drug payments for all 3 years.The largest change in share was a modest increase for the disabled which experienced an increase from 71.4 percent of the total spending for CNS drugs in 1996 to 72.9 percent in 1998.From 1996 to 1998 there was virtually no shift in the share of payments for CNS prescription drugs based on eligibility. The aged received about 19 percent, the disabled received about 72 percent, adults received about 5.5 percent and children received only 3.2 percent.By no means should these seemingly mild changes in spending shares indicate that CNS drug spending is under control. The unchanging nature of the share of payments may actually be a concern for the Medicaid Program since payments for these years may serve as indicators that high CNS payments could burden Medicaid for the foreseeable future. The breakdown of payments by basis of eligibility for these 3 years merely indicates how CNS drug payments have been channeled to these 4 segments of the population.
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
Related in: MedlinePlus