Elmarasi Mohamed, Fuehrlein Brian
Department of psychiatry, Nassau University Medical Center, United States.
Psychiatry, Yale University, New Haven, CT, United States.
Explor Res Clin Soc Pharm. 2023 Dec 5;13:100392. doi: 10.1016/j.rcsop.2023.100392. eCollection 2024 Mar.
Major depressive disorder (MDD) is a serious mental health condition that contributes to health complications, financial burden and death. In 2020, about one in five US adults had a lifetime diagnosis of MDD With Major Depressive Disorder (MDD) being a common mental health concern, it is important to understand treatment patterns within public health systems like Medicaid, as they play a crucial role in providing care to diverse populations.
The study investigated antidepressant usage and market distribution in the Medicaid Program. By doing so, the study aimed to provide insights into how these trends reflect broader changes in mental health treatment practices and policy implications within the Medicaid system during the study period.
Public Medicaid data from 2017 to 2021 were analyzed, focusing on 30 FDA-approved antidepressants. Spending and prescription data were aggregated using Excel and Python.
The total US Medicaid expenditure on antidepressants increased from about $1 billion dollars in 2017 to $1.12 billion dollars in 2021, an increase of about 10%. Consistently, SSRIs were the class of antidepressants that Medicaid spent the most on. The highest Medicaid spending on a single antidepressant in 2017 and 2018 was bupropion. During the remaining years of the study (2019, 2020, 2021) Medicaid appropriated most funds toward Vortioxetine. The total number of antidepressant prescriptions increased from 52 million scripts to 59 million scripts (an increase of about 14%).
The increase in Medicaid spending on antidepressants during the study period can be explained by an increase in utilization (a 14% increase in antidepressant prescriptions from 2017 to 2021), and a shift toward prescribing newer more costly antidepressants (like SSRIs and others) and away from prescribing older, less costly antidepressants like monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs)."
重度抑郁症（MDD）是一种严重的心理健康状况，会导致健康并发症、经济负担和死亡。2020年，约五分之一的美国成年人一生中有过重度抑郁症的诊断。由于重度抑郁症是一个常见的心理健康问题，了解像医疗补助计划这样的公共卫生系统中的治疗模式很重要，因为它们在为不同人群提供护理方面发挥着关键作用。
该研究调查了医疗补助计划中的抗抑郁药使用情况和市场分布。通过这样做，该研究旨在深入了解这些趋势如何反映研究期间医疗补助系统中心理健康治疗实践的更广泛变化以及政策影响。
分析了2017年至2021年的公共医疗补助数据，重点关注30种美国食品药品监督管理局（FDA）批准的抗抑郁药。使用Excel和Python汇总支出和处方数据。
美国医疗补助计划在抗抑郁药上的总支出从2017年的约10亿美元增加到2021年的11.2亿美元，增长了约10%。一直以来，选择性5-羟色胺再摄取抑制剂（SSRI）类是医疗补助计划支出最多的抗抑郁药类别。2017年和2018年医疗补助计划在单一抗抑郁药上支出最高的是安非他酮。在研究的剩余年份（2019年、2020年、2021年），医疗补助计划将大部分资金用于伏硫西汀。抗抑郁药处方总数从5200万份增加到5900万份（增长了约14%）。
研究期间医疗补助计划在抗抑郁药上支出的增加可以通过利用率的提高（从2017年到2021年抗抑郁药处方增加了14%）以及处方转向更新、更昂贵的抗抑郁药（如SSRI类及其他），远离像单胺氧化酶抑制剂（MAOI）和三环类抗抑郁药（TCA）等较旧、成本较低的抗抑郁药来解释。
