Goddard Andrew W, Schwartz Katherine, Hendrix Kristin, Aalsma Matthew C, Slaven James, Hancock Emily F, Lambert David, Downs Stephen, Rosenman Marc
Dr. Goddard is with the Department of Psychiatry, University of California, San Francisco, Fresno (e-mail:
Psychiatr Serv. 2016 Sep 1;67(9):1030-4. doi: 10.1176/appi.ps.201500061. Epub 2016 May 16.
To replicate and extend a study by the Agency for Healthcare Research and Quality (AHRQ) and Rutgers on antipsychotic use among youths in Medicaid, the authors analyzed Indiana Medicaid claims from 2004 to 2012, extending the earlier study by focusing on second-generation antipsychotics, including both fee-for-service (FFS) and non-FFS patients, and analyzing cost trends.
The authors evaluated the impact of several Indiana Medicaid policy changes on medication utilization and cost among children enrolled for at least one month during 2004-2012 (N=683,716-793,637), using an exhaustive antipsychotic list to search the database.
Annual utilization rates for antipsychotics were 2%-3% but were much higher among foster children (10%-15%). Policies implemented in 2007 or later were associated with a significant plateauing of utilization in 2008-2012.
Growth of second-generation antipsychotic utilization and costs was similar to trends described in the AHRQ-Rutgers study. Several containment strategies appeared effective in addressing these trends.
为了重复并拓展医疗保健研究与质量局（AHRQ）和罗格斯大学开展的一项关于医疗补助计划中青少年使用抗精神病药物的研究，作者分析了2004年至2012年印第安纳州医疗补助计划的理赔数据，通过聚焦第二代抗精神病药物（包括按服务收费[FFS]患者和非FFS患者）并分析成本趋势来扩展早期研究。
作者评估了印第安纳州几项医疗补助政策变化对2004 - 2012年期间至少参保一个月的儿童（N = 683,716 - 793,637）用药情况和成本的影响，使用一份详尽的抗精神病药物清单在数据库中进行检索。
抗精神病药物的年使用率为2% - 3%，但寄养儿童中的使用率要高得多（10% - 15%）。2007年或之后实施的政策与2008 - 2012年使用率显著趋于平稳相关。
第二代抗精神病药物使用量和成本的增长与AHRQ - 罗格斯大学研究中描述的趋势相似。几种控制策略似乎对应对这些趋势有效。
