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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) Payment Per Prescription for 29 SMRF States, by Basis of Eligibility: 1996-1998In the 29 SMRF States, Disabled Beneficiaries Had the Highest Payment Per Prescription for CNS Drugs for All 3 YearsPayment per prescription for CNS drugs for the disabled was $40 in 1996, $51 in 1997, and $70 in 1998. In contrast, payment per prescription for CNS drugs was lowest in all three years for the aged at $25 in 1996, $32 in 1997, and $43 in 1998.In 1998, payment per prescription for CNS drugs for the disabled at $70, was substantially higher compared to the payment per prescription for CNS drugs for the other basis of eligibility groups - $52 for adults, $49 for children, and $43 for the aged.The percentage increase in payment per prescription for all four basis of eligibility groups was greater from 1997 to 1998 than it was for 1996 to 1997. Payment per prescription for the disabled increased by 25.86 percent from 1996 to 1997, and another 38.21 percent from 1997 to 1998.As high as these increases were for the disabled, payment per prescription grew at an even higher rate for children (33.72 percent from 1996 to 1997, and 43.58 percent from 1997 to 1998). The increase from 1996 to 1997 was also higher for the aged than it was-for the disabled.
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f6-hcfr-26-1-057: Medicaid Central Nervous System (CNS) Payment Per Prescription for 29 SMRF States, by Basis of Eligibility: 1996-1998In the 29 SMRF States, Disabled Beneficiaries Had the Highest Payment Per Prescription for CNS Drugs for All 3 YearsPayment per prescription for CNS drugs for the disabled was $40 in 1996, $51 in 1997, and $70 in 1998. In contrast, payment per prescription for CNS drugs was lowest in all three years for the aged at $25 in 1996, $32 in 1997, and $43 in 1998.In 1998, payment per prescription for CNS drugs for the disabled at $70, was substantially higher compared to the payment per prescription for CNS drugs for the other basis of eligibility groups - $52 for adults, $49 for children, and $43 for the aged.The percentage increase in payment per prescription for all four basis of eligibility groups was greater from 1997 to 1998 than it was for 1996 to 1997. Payment per prescription for the disabled increased by 25.86 percent from 1996 to 1997, and another 38.21 percent from 1997 to 1998.As high as these increases were for the disabled, payment per prescription grew at an even higher rate for children (33.72 percent from 1996 to 1997, and 43.58 percent from 1997 to 1998). The increase from 1996 to 1997 was also higher for the aged than it was-for the disabled.


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) Payment Per Prescription for 29 SMRF States, by Basis of Eligibility: 1996-1998In the 29 SMRF States, Disabled Beneficiaries Had the Highest Payment Per Prescription for CNS Drugs for All 3 YearsPayment per prescription for CNS drugs for the disabled was $40 in 1996, $51 in 1997, and $70 in 1998. In contrast, payment per prescription for CNS drugs was lowest in all three years for the aged at $25 in 1996, $32 in 1997, and $43 in 1998.In 1998, payment per prescription for CNS drugs for the disabled at $70, was substantially higher compared to the payment per prescription for CNS drugs for the other basis of eligibility groups - $52 for adults, $49 for children, and $43 for the aged.The percentage increase in payment per prescription for all four basis of eligibility groups was greater from 1997 to 1998 than it was for 1996 to 1997. Payment per prescription for the disabled increased by 25.86 percent from 1996 to 1997, and another 38.21 percent from 1997 to 1998.As high as these increases were for the disabled, payment per prescription grew at an even higher rate for children (33.72 percent from 1996 to 1997, and 43.58 percent from 1997 to 1998). The increase from 1996 to 1997 was also higher for the aged than it was-for the disabled.
© Copyright Policy
Related In: Results  -  Collection

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

f6-hcfr-26-1-057: Medicaid Central Nervous System (CNS) Payment Per Prescription for 29 SMRF States, by Basis of Eligibility: 1996-1998In the 29 SMRF States, Disabled Beneficiaries Had the Highest Payment Per Prescription for CNS Drugs for All 3 YearsPayment per prescription for CNS drugs for the disabled was $40 in 1996, $51 in 1997, and $70 in 1998. In contrast, payment per prescription for CNS drugs was lowest in all three years for the aged at $25 in 1996, $32 in 1997, and $43 in 1998.In 1998, payment per prescription for CNS drugs for the disabled at $70, was substantially higher compared to the payment per prescription for CNS drugs for the other basis of eligibility groups - $52 for adults, $49 for children, and $43 for the aged.The percentage increase in payment per prescription for all four basis of eligibility groups was greater from 1997 to 1998 than it was for 1996 to 1997. Payment per prescription for the disabled increased by 25.86 percent from 1996 to 1997, and another 38.21 percent from 1997 to 1998.As high as these increases were for the disabled, payment per prescription grew at an even higher rate for children (33.72 percent from 1996 to 1997, and 43.58 percent from 1997 to 1998). The increase from 1996 to 1997 was also higher for the aged than it was-for the disabled.
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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