Abstract
While some studies show a significant advantage in adherence rates with use of atypical versus typical antipsychotic medication, others show no advantage or mixed results (Jones et al. (2006). Archives of General Psychiatry, 63, 1079–1087; Rosenheck, (2006). Archives of General Psychiatry, 63, 1074–1076). This study examined treatment outcomes and costs associated with adherence rates by antipsychotic medication class for adult Medicaid beneficiaries in Florida diagnosed with schizophrenia. Outcomes examined include arrests, involuntary commitments, and physical and behavioral healthcare costs. Study findings demonstrate that medication adherence for persons with schizophrenia may be as important to treatment costs and benefits as the class of medication used.
Similar content being viewed by others
References
Andreasen, N. C., Carpenter, W. T., Kane, J. M., Lasser, R. A., Marder, S. R., & Weinberger, D. R. (2005). Remission in schizophrenia: Proposed criteria and rationale for consensus. American Journal of Psychiatry, 162, 441–449.
Awad, A. G., & Voruganti, L. N. (2004). New antipsychotics, compliance, quality of life, and subjective tolerability—Are patients better off? Canadian Journal of Psychiatry, 49(5), 297–302.
Baker, F. M., & Bell, C. (1999). Issues in the psychiatric treatment of African Americans. Psychiatric Services, 50(3), 362–350.
Becker, M., & Diamond, R. (2005). Quality of life measurement in persons with schizophrenia: Are we measuring what’s important? In H. Katschnig & H. Freeman (Eds.), Quality of life in mental disorders (2nd ed.). Chichester, England: Wiley.
Becker, M., Jang, Y., & Kane, M. (2006). Evaluation of Florida Medicaid behavioral health pharmacy practice by racial/ethnic minorities across the lifespan (pp. 1–27). Tampa, FL: Louis de la Parte Florida Mental Health Institute, University of South Florida.
Becker, M., & Lemrow, N. (2004). Behavioral health care services associated with switching atypical antipsychotic medication for persons with SMI (pp. 1–76). Tampa, FL: Louis de la Parte Florida Mental Health Institute, University of South Florida.
Boyd, D. L. (2003). The bursting State Fiscal Bubble and State Medical Budgets. Health Affairs, 22(1), 46–61.
Brown, C., Markowitz, J., Moore, T., & Parker, N. (1999). Atypical antipsychotics, part II: Adverse effects, drug interactions, and costs. Annals of Pharmacotherapy, 33, 210–217.
Csernansky, J. G., & Schuchart, E. K. (2002). Relapse and rehospitalisation rates in patients with schizophrenia: Effects of second generation antipsychotics. CNS Drugs, 16, 473–484.
Daumit, G. L., Crum, R. M., Guallar, E., et al. (2003). Outpatient prescriptions for atypical antipsychotics for African Americans, Hispanics, and Whites in the United States. Archives of General Psychiatry, 60, 121–128.
Davis, J. M., Chen, N., & Glick, I. D. (2003). A meta-analysis of the efficacy of second generation antipsychotics. Archive of General Psychiatry, 60, 553–564.
Dolder, C. R., Lacro, J. P., Dunn, L. B., et al. (2002). Antipsychotic medication adherence: Is there a difference between typical and atypical agents? American Journal of Psychiatry, 159, 103–108.
Dolder, C. R., Lacro, J. P., & Jeste, D. V. (2003). Adherence to antipsychotic and nonpsychiatric medications in middle-aged and older patients with psychotic disorders. Psychosomatic Medicine, 65, 156–162.
Eaddy, M., Grogg, A., & Locklear, J. (2005). Assessment of compliance with antipsychotic treatment and resource utilization in a Medicaid population. Clinical Therapeutic, 27(2), 263–272.
Fenton, W. S., Blyler, C. R., & Heinssen, R. K. (1997). Determinants of medication compliance in schizophrenia: Empirical and clinical findings. Schizophrenia Bulletin, 23(4), 637–651.
Fichtner, C. G., Hanrahan, P., & Luchins, D. J. (1998). Pharmacoeconomic studies of atypical antipsychotics: Review and perspective. Psychiatric Annals, 28(7), 381–396.
Foster, R. H., & Goa, K. L. (1999). Olanzapine: A pharmacoeconomic review of its use in schizophrenia. Pharmacoeconomics, 15, 611–640.
Gardner, J. C., Luo, Z., Bradley, C. J., Polverrjan, E., Holmes-Rovnes, M., & Rovner, D. (2003). Longitudinal assessment of cost in health care intervention. Health Services Research Methodology, 3, 149–168.
Geddes, J., Freemantle, N., Harrison, P., & Bebbington, P. (2000). Atypical antipsychotics in treatment of schizophrenia: Systematic overview and meta-regression analysis. British Nursing Journal, 321, 1371–1376.
Gibson, J., Damler, R., Jackson, A. E., Wilder, T., & Ramsey, J. L. (2004). The impact of olanzapine, risperidone, or haldol on the cost of schizophrenia care in a Medicaid population. Value in Health, 7(1), 22–35.
Glazer, W. M. (1998). Formulary decisions and health economics. Journal of Clinical Psychiatry, 59(Suppl. 19), 23–29.
Hargraves, W. A., & Shumway, M. (1996). Pharmacoeconomics of antipsychotic drug therapy. Journal of Clinical Psychiatry, 57(Suppl. 9), 66–76.
Haynes, R. B. (1979). Introduction. In R. B. Haynes, D. L. Sackett, & D. W. Taylor (Eds.), Compliance in health care (pp. 1–10). Baltimore, MD: John Hopkins University Press.
Herbeck, D. M., West, J. C., Ruditis, I., et al. (2004). Variations in use of second-generation antipsychotic medication by race among adult psychiatric patients. Psychiatric Services, 55, 677–684.
Hogan, M. F. (1999). Public-sector mental health care: New challenges. Health Affairs, 18, 106–111.
Javaid, J. I., Holland, D., & Janicak, P. G. (1991). Blood level monitoring of antipsychotics and antidepressants. Psychiatric Medicine, 9(1), 163–187.
Jones, K., Chen, H. J., Jordan, N., Boothroyd, R. A., Ramoni-Perazzi, J., & Shern, D. L. (2006). Examination of formal treatment costs in the provision of managed care for a Medicaid population with psychiatric disabilities. Medical Care, 44, 320–327.
Jones, P., Barnew, T., Davies, L., Dunn, G., Lloyd, H., Hayhurst, K., Murray, R., Markwick, A., & Lewis, S. (2006). Randomized controlled trial of the effect on quality of life of second- vs first-generation antipsychotic drugs in schizophrenia. Archives of General Psychiatry, 63, 1079–1087.
Lacro, J. P., Dunn, L. B., Dolder, C. R., Leckband, S. G., & Jeste, D. V. (2002). Prevalence of and risk factors for medication nonadherence in patients with schizophrenia: A comprehensive review of recent literature. Journal of Clinical Psychiatry, 63(10), 892–909.
Lehman, A. F., & Steinwachs, D. M. (1998). Translating research into practice: the schizophrenia patient outcomes research team (PORT) treatment recommendations. Schizophrenia Bulletin, 24, 1–10.
Lieberman, J. A., Stroup, T. S., McEvoy, J. P., Swartz, M. S., Rosenheck, R., Perkins, D., Keefe, R., Davis, S., Davis, C., Lebowitz, B., Severe, J., & Hsiano, J. (2005). Clinical antipsychotic trials of intervention effectiveness (CATIE) investigators. Effectiveness of antipsychotic drugs in patients with schizophrenia. New England Journal of Medicine, 353, 1209–1223.
McCombs, J. S., Nichol, M. B., Johnstone, B. M., Stimmel, G. L., Shi, J., & Smith, R. (2000). Antipsychotic drug use patterns and the cost of treating schizophrenia. Psychiatric Services, 51(4), 525–527.
Mojtabai, R., Lavelle, J., Gibson, P.J., et al. (2002). Gaps in use of antipsychotics after discharge by first-admission patients with schizophrenia, 1989–1996. Psychiatric Services, 53(3), 337–339.
Moy, E., Dayton, E., & Clancy, C. M. (2005). Compiling the evidence: The national healthcare disparities reports. Public Response, March/April, pp. 376–386.
Naber, D., Moritz, S., Lambert, M., et al. (2001). Improvement of schizophrenic patients’ subjective well-being under atypical antipsychotic drugs. Schizophrenia Research, 50, 79–88.
Nicole, L. (2005). Health disparities—Less talk more action. New England Journal of Medicine, 35(7), 727–729.
Olivieri, N., Matsui, D., Hermann, C., & Koren, G. (1991). Compliance assessed by the medication event monitoring system. Archives of Disease in Childhood, 66, 1399–1402.
Pandiana, J. A., & Banks, S. M. (2003). Large data sets are powerful. Psychiatric Services, 54, 745.
Ren, X. S., Kazia, L. E., Lee, A. F., et al. (2002). Patient characteristics and prescription patterns of atypical antipsychotics among patients with schizophrenia. Journal of Pharmacy and Therapeutics, 27, 441–451.
Rice, D. P. (1999). The economic impact of schizophrenia. Journal of Clinical Psychiatry, 60(Suppl. 1), 4–6.
Rittmannsberger, H., Pachinger, T., Keppelmuller, P., & Wancata, J. (2004). Medication adherence among psychotic patients before admission to inpatient treatment. Psychiatric Services, 55(2), 174–179.
Rosenheck, R. (2006). Outcomes, costs, and policy caution: A commentary on the cost utility of the latest antipsychotic drugs in schizophrenia study (CUtLASS 1). Archives of General Psychiatry, 63, 1074–1076.
Rosenheck, R., Perlick, D., Bingham, S., et al. (2003). Effectiveness and cost of olanzapine and haloperidol in the treatment of schizophrenia. Journal of the American Medical Association, 290(20), 2693–2702.
Schneider, E. C., Zaslavsky, A. M., & Epstein, A. M. (2002). Racial disparities in the quality of care for enrollees in medicare managed care. Journal of the American Medical Association, 287(10), 1288–1294.
Shern, D., Robinson, P., Giard, J., & Vargo, A., et al. (2005). Evaluation of Florida’s Medicaid Managed Mental Health Plans: Year 8 Report Tampa, FL: Louis de la Parte Florida Mental Health Institute, University of South Florida.
Svarstad, B. L., Shireman, T. I., & Sweeney, J. K. (2001). Using drug claims data to assess the relationship of medication adherence with hospitalization and costs. Psychiatric Services, 52, 805–811.
Tandon, R. (1998). In conclusion, does antipsychotic treatment modify the long-term course of schizophrenic illness? Journal of Psychiatric Research, 32, 251–253.
Thieda, P., Beard, S., Richter, A., & Kane, J. (2003). An economic review of compliance with medication therapy in the treatment of schizophrenia. Psychiatric Services, 54(4), 508–516.
Valenstein, M., Blow, F. C., Copeland, L. A., Mcarthy, J. F., et al. (2004). Poor antipsychotic adherence among patients with schizophrenia: Medication and patient factors. Schizophrenia Bulletin, 30(2), 255–264.
Vanelli, M., Burstein, P., & Crammer, J. (2001). Refill patterns of atypical and conventional antipsychotic medication at a national retail pharmacy chain. Psychiatric Services, 52, 1248–1250.
Weiden, P., Aquila, R., & Standard, J. (1996). Atypical antipsychotic drugs and long-term outcome in schizophrenia. Journal of Clinical Psychiatry, 57(Suppl. ll), 53–60.
Weiden, P. J., Kozma, C., Grogg, A., & Locklear, J. (2004). Partial compliance and risk of rehospitalization among California Medicaid patients with schizophrenia. Psychiatric Services, 55(8), 886–891.
Weiden, P. J., & Olfson, M. (1995). Cost of relapse in schizophrenia. Schizophrenia Bulletin, 21, 419–429.
Weiden, P., & Zygmunt, A. (1997). Medication noncompliance in schizophrenia. Part I. Assessment. Journal of Practical Psychiatry and Behavioral Health, 3, 106–110.
Wyatt, R. J., Henter, I., Leary, M. C., & Taylor, E. (1995). An economic evaluation of schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 30, 196–205.
Ziguras, S. J., Klimidis, S., Lambert, T. J. R., & Jackson, A. C. (2001). Determinants of anti-psychotic medication compliance in a multicultural population. Community Mental Health Journal, 37(3), 273–283.
Author information
Authors and Affiliations
Corresponding author
Additional information
This paper was previously presented at the Academy Health Research Meeting: Becker, M.A., (June, 2005). Antipsychotic medication in schizophrenia: What is the impact of adherence on treatment outcomes. Paper presented at the Academy Health Research Meeting, Boston, M.A.
Rights and permissions
About this article
Cite this article
Becker, M.A., Young, M.S., Ochshorn, E. et al. The Relationship of Antipsychotic Medication Class and Adherence with Treatment Outcomes and Costs for Florida Medicaid Beneficiaries with Schizophrenia. Adm Policy Ment Health 34, 307–314 (2007). https://doi.org/10.1007/s10488-006-0108-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10488-006-0108-5