Short-term impact of preferred drug list changes on health care use and Medicaid costs: injectable risperidone

Psychiatr Serv. 2010 Sep;61(9):937-9. doi: 10.1176/ps.2010.61.9.937.

Abstract

Objective: This study assessed short-term effects of the removal of injectable risperidone long-acting therapy from the Florida Medicaid preferred drug list (PDL) in April 2006.

Methods: A difference-in-difference approach was used to contrast changes (60 days pre and post) in health care utilization and costs of Medicaid recipients who were receiving risperidone long-acting therapy when the policy was changed (N=247) and of a matched sample who received risperidone long-acting therapy in April 2005 (non-PDL, N=247).

Results: The policy change was associated with increased acute care events. Whereas acute care events declined for the non-PDL group, involuntary commitments and total acute care events increased for the PDL group, as did expenditures for crisis-related events. Medicaid pharmacy costs fell for both groups, but total expenditures did not decline significantly for the PDL group.

Conclusions: The PDL restriction was associated with increased acute care events and did not reduce short-term Medicaid program expenditures.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / therapeutic use*
  • Female
  • Florida
  • Formularies as Topic*
  • Health Expenditures / trends
  • Health Services / statistics & numerical data
  • Humans
  • Injections, Intravenous*
  • Insurance Claim Review
  • Male
  • Medicaid / economics*
  • Middle Aged
  • Policy Making
  • Risperidone / administration & dosage
  • Risperidone / therapeutic use*
  • United States

Substances

  • Antipsychotic Agents
  • Risperidone