Coverage and prior authorization of psychotropic drugs under Medicare Part D

Haiden A. Huskamp, David G. Stevenson, Julie M. Donohue, Joseph P. Newhouse, Nancy L. Keating, Steven S. Sharfstein, Alison Evans Cuellar

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)308-310
Number of pages3
JournalPsychiatric Services
Volume58
Issue number3
DOIs
StatePublished - Mar 2007

ASJC Scopus subject areas

  • Psychiatry and Mental health

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