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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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Related in: MedlinePlus

Medicaid Payment Per Prescription for Central Nervous System (CNS) Drugs for 29 SMRF States, by Basis of Eligibility and CNS Drug Group: 1998Payment Per Prescription for Anti-Psychotics was Much Higher Than for Other CNS Drug Groups in the 29 SMRF States Between 1996 and 1998Payment per prescription for anti-psychotics ranged from a high of $114 for disabled eligibles, $85 for children, $84 for adults, and a low of $65 for aged eligibles. Per prescription, anti-psychotics were more costly than other CNS drug groups, regardless of basis of eligibility.Anti-depressants was the second most costly CNS drug group. However, the difference by basis of eligibility was relatively small for anti-depressants, ranging from a low of $46 for the aged to a high of $62 for adults.Per prescription payment for anti-anxiety drugs was lowest for children at $16 and highest for the disabled at $32.Among these CNS drug groups, hypnotics was the least costly CNS drug group per prescription, ranging from a low of $10 for children to a high of $29 for adults.
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f7-hcfr-26-1-057: Medicaid Payment Per Prescription for Central Nervous System (CNS) Drugs for 29 SMRF States, by Basis of Eligibility and CNS Drug Group: 1998Payment Per Prescription for Anti-Psychotics was Much Higher Than for Other CNS Drug Groups in the 29 SMRF States Between 1996 and 1998Payment per prescription for anti-psychotics ranged from a high of $114 for disabled eligibles, $85 for children, $84 for adults, and a low of $65 for aged eligibles. Per prescription, anti-psychotics were more costly than other CNS drug groups, regardless of basis of eligibility.Anti-depressants was the second most costly CNS drug group. However, the difference by basis of eligibility was relatively small for anti-depressants, ranging from a low of $46 for the aged to a high of $62 for adults.Per prescription payment for anti-anxiety drugs was lowest for children at $16 and highest for the disabled at $32.Among these CNS drug groups, hypnotics was the least costly CNS drug group per prescription, ranging from a low of $10 for children to a high of $29 for adults.

Mentions: Payment per recipient for anti-psychotics for the disabled ($1,188) was nearly three times the amount for the aged ($443) and children ($438) and nearly five times the amount for adults ($215). This finding is the result of at least two major factors: payment and utilization. Payment per prescription for anti-psychotics for the disabled was very high (Figure 7). Also, utilization of anti-psychotics by the disabled was also very high (Figure 8).


Medicaid spending and utilization for central nervous system drugs.

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

Medicaid Payment Per Prescription for Central Nervous System (CNS) Drugs for 29 SMRF States, by Basis of Eligibility and CNS Drug Group: 1998Payment Per Prescription for Anti-Psychotics was Much Higher Than for Other CNS Drug Groups in the 29 SMRF States Between 1996 and 1998Payment per prescription for anti-psychotics ranged from a high of $114 for disabled eligibles, $85 for children, $84 for adults, and a low of $65 for aged eligibles. Per prescription, anti-psychotics were more costly than other CNS drug groups, regardless of basis of eligibility.Anti-depressants was the second most costly CNS drug group. However, the difference by basis of eligibility was relatively small for anti-depressants, ranging from a low of $46 for the aged to a high of $62 for adults.Per prescription payment for anti-anxiety drugs was lowest for children at $16 and highest for the disabled at $32.Among these CNS drug groups, hypnotics was the least costly CNS drug group per prescription, ranging from a low of $10 for children to a high of $29 for adults.
© Copyright Policy
Related In: Results  -  Collection

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

f7-hcfr-26-1-057: Medicaid Payment Per Prescription for Central Nervous System (CNS) Drugs for 29 SMRF States, by Basis of Eligibility and CNS Drug Group: 1998Payment Per Prescription for Anti-Psychotics was Much Higher Than for Other CNS Drug Groups in the 29 SMRF States Between 1996 and 1998Payment per prescription for anti-psychotics ranged from a high of $114 for disabled eligibles, $85 for children, $84 for adults, and a low of $65 for aged eligibles. Per prescription, anti-psychotics were more costly than other CNS drug groups, regardless of basis of eligibility.Anti-depressants was the second most costly CNS drug group. However, the difference by basis of eligibility was relatively small for anti-depressants, ranging from a low of $46 for the aged to a high of $62 for adults.Per prescription payment for anti-anxiety drugs was lowest for children at $16 and highest for the disabled at $32.Among these CNS drug groups, hypnotics was the least costly CNS drug group per prescription, ranging from a low of $10 for children to a high of $29 for adults.
Mentions: Payment per recipient for anti-psychotics for the disabled ($1,188) was nearly three times the amount for the aged ($443) and children ($438) and nearly five times the amount for adults ($215). This finding is the result of at least two major factors: payment and utilization. Payment per prescription for anti-psychotics for the disabled was very high (Figure 7). Also, utilization of anti-psychotics by the disabled was also very high (Figure 8).

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