The geography of antidepressant, antipsychotic, and stimulant utilization in the United States.
This paper analyzes local and regional geographic variability in the use of antidepressant, antipsychotic and stimulant medications in the United States. Using a data set that covers 60% of prescriptions written in the United States, we find that use of antidepressants in three digit postal codes ranged from less than 1% of residents to more than 40% residents. Stimulant and antipsychotic use exhibited similar levels of local geographic variability. A Kulldorf Spatial Scan identified clusters of elevated use of antidepressants (RR 1.46; p<0.001), antipsychotics (RR 1.42; p<0.001), and stimulants (RR 1.77; p<0.001). Using a multilevel model, we find that access to health care, insurance coverage and pharmaceutical marketing efforts explain much of the geographic variation in use.
Yale School of Management, 135 Prospect Street, New Haven, CT 06511, USA. marissa.king@yale.edu
Marissa
M
King
Connor
C
Essick
D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D016208:Databases, Factual; D062306:Geography, Medical; D006297:Health Services Accessibility; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D040541:Marketing; D014481:United States
D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D000697:Central Nervous System Stimulants