Cluster analysis of state Medicaid prescription drug benefit programs based on potential determinants of per capita drug expenditure.
BACKGROUND
Drug cost-containment strategies result in varied outcomes in different state Medicaid programs perhaps, because they differ in ways beyond the usual considerations of similarity among the states and their Medicaid populations.


OBJECTIVE
To classify state Medicaid programs into homogenous groups based on potential determinants of their prescription drug expenditures.


METHODS
Cluster analysis techniques were used to identify clusters of state Medicaid programs, and their characteristics, using variables identified as potential determinants of Medicaid prescription drug expenditures.


RESULTS
Five distinct clusters were identified with memberships ranging from 1 to 24 states. Sociodemographic factors like race/ethnicity and elderly persons in Medicaid, severity of diseases, state population covered by Medicaid, population below poverty level, and high-school graduates; access factors like access to hospitals, pharmacies, physicians, and prenatal care; and policy factors like support for publicly funded health care were identified as key characteristics that distinguished among these clusters. Per capita prescription drug expenditure was also found to be significantly different among these clusters.


CONCLUSIONS
Knowledge of clusters among state Medicaid programs and their characteristics could potentially increase the chances of success for Medicaid administrative policies and interventions at lower costs of targeted implementation.
Roy
Sanjoy
S
Department of Pharmaceutical Systems and Policy, PO Box 9510, Robert C Byrd Health Sciences Center, West Virginia University, Morgantown, WV 26505, USA. sanjroy@gmail.com
Madhavan
S Suresh
SS
D016000:Cluster Analysis; D003363:Cost Control; D005102:Health Expenditures; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000191:economics*; D008484:Medicaid / Q000191:economics*; D055553:Prescription Drugs / Q000191:economics*; D012959:Socioeconomic Factors; D014481:United States
D055553:Prescription Drugs