title: Medicaid coverage and utilization of covered tobacco-cessation treatments: the Arkansas experience.
abstract: BACKGROUND
  Although most Medicaid programs have some coverage for tobacco-cessation treatments, little is known about how well the covered treatments are utilized among Medicaid enrollees.
  
  
  OBJECTIVE
  To examine the impact of Arkansas Medicaid coverage of tobacco-cessation treatment on utilization of FDA-approved tobacco-cessation pharmacotherapies and counseling services by Medicaid enrollees.
  
  
  METHODS
  This study used Arkansas Medicaid administrative claims data from October 1, 2003, to June 30, 2008. Trend changes in the following monthly measures were examined: (1) total number of pharmacy claims for each covered pharmacotherapy; (2) total number of medical claims for counseling services; and (3) total number of unique enrollees who received each type of covered tobacco-cessation treatment. Average unit of defined daily dose and days with treatment stratified by tobacco-cessation products within 180 days after the first tobacco-cessation treatment were examined for intensity of treatment. Data collection was finished in 2009 and analysis was completed in 2011.
  
  
  RESULTS
  By June 30, 2008, a total of 12,673 enrollees received some tobacco-cessation treatments, and 77% of them received pharmacotherapies only. Implementation of the coverage expansion generated an initial increase in utilization of tobacco-cessation medications but quickly declined after 3 months. Utilization increased again when varenicline was added, but also decreased sharply after 6 months. Patterns of monthly claims for counseling services appeared to be inconsistent with the policy change.
  
  
  CONCLUSIONS
  Medicaid coverage alone may have limited sustained effect on increasing utilization of the covered tobacco-cessation treatments among Medicaid enrollees.
authors.affiliation: Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR 72205, USA. cli@uams.edu
authors.forename: Chenghui
authors.initials: C
authors.lastname: Li
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Dresler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001131:Arkansas; D002648:Child; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D008875:Middle Aged; D020340:Tobacco Use Cessation / Q000379:methods*; D014481:United States; D055815:Young Adult