TY - JOUR
T1 - Coverage and prior authorization of psychotropic drugs under Medicare Part D
AU - Huskamp, Haiden A.
AU - Stevenson, David G.
AU - Donohue, Julie M.
AU - Newhouse, Joseph P.
AU - Keating, Nancy L.
AU - Sharfstein, Steven S.
AU - Cuellar, Alison Evans
PY - 2007/3
Y1 - 2007/3
N2 - This study examined formulary coverage and use of utilization management tools for three classes of psychotropic medications (antidepressants, antipsychotics, and anticonvulsants) among Medicare Part D prescription drug plans serving individuals dually eligible for the Medicare and Medicaid programs. Plans must cover "all or substantially all" molecules (distinct drugs) in these classes. Plans serving "dual eligibles" generally covered at least one formulation of all molecules in the three classes. However, certain product formulations were not covered by a number of plans, and use of prior authorization was common for a minority of plans. The effect of Part D will depend on the restrictiveness of the prior authorization and appeals processes, which is currently unknown.
AB - This study examined formulary coverage and use of utilization management tools for three classes of psychotropic medications (antidepressants, antipsychotics, and anticonvulsants) among Medicare Part D prescription drug plans serving individuals dually eligible for the Medicare and Medicaid programs. Plans must cover "all or substantially all" molecules (distinct drugs) in these classes. Plans serving "dual eligibles" generally covered at least one formulation of all molecules in the three classes. However, certain product formulations were not covered by a number of plans, and use of prior authorization was common for a minority of plans. The effect of Part D will depend on the restrictiveness of the prior authorization and appeals processes, which is currently unknown.
UR - http://www.scopus.com/inward/record.url?scp=33947611154&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33947611154&partnerID=8YFLogxK
U2 - 10.1176/appi.ps.58.3.308
DO - 10.1176/appi.ps.58.3.308
M3 - Article
C2 - 17325102
AN - SCOPUS:33947611154
SN - 1075-2730
VL - 58
SP - 308
EP - 310
JO - Psychiatric Services
JF - Psychiatric Services
IS - 3
ER -