title: Economic grand rounds: experience with mandated use of generic medications for patients covered by the mental health safety net.
abstract: Reducing pharmacy costs without increasing adverse outcomes would relieve some pressure on mental health budgets. This column describes the experience of a publicly funded provider network in a Michigan county that mandated generic use of psychotropic medications to address financial challenges. The percentage of brand-name medications and cost per prescription declined with the policy change, resulting in lower total pharmacy expenditures. No increase was noted in prescriptions per patient or psychiatric hospitalizations. Changes were sustained after the initial implementation period. Mandating generic use may be feasible as a tool for constraining pharmacy costs in mental health budgets.
authors.affiliation: Dr. Amirsadri and Dr. Arfken are with the Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit. Dr. Chapman is with Gateway Community Health, Detroit. Mr. Breen and Dr. Drake are with Advanced Care, Shelby Township, Michigan. Send correspondence to Dr. Arfken (e-mail: carfken@med.wayne.edu). Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
authors.forename: Alireza
authors.initials: A
authors.lastname: Amirsadri
authors.affiliation: Dr. Amirsadri and Dr. Arfken are with the Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit. Dr. Chapman is with Gateway Community Health, Detroit. Mr. Breen and Dr. Drake are with Advanced Care, Shelby Township, Michigan. Send correspondence to Dr. Arfken (e-mail: carfken@med.wayne.edu). Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
authors.forename: Timothy
authors.initials: T
authors.lastname: Chapman
authors.affiliation: Dr. Amirsadri and Dr. Arfken are with the Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit. Dr. Chapman is with Gateway Community Health, Detroit. Mr. Breen and Dr. Drake are with Advanced Care, Shelby Township, Michigan. Send correspondence to Dr. Arfken (e-mail: carfken@med.wayne.edu). Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
authors.forename: Michael
authors.initials: M
authors.lastname: Breen
authors.affiliation: Dr. Amirsadri and Dr. Arfken are with the Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit. Dr. Chapman is with Gateway Community Health, Detroit. Mr. Breen and Dr. Drake are with Advanced Care, Shelby Township, Michigan. Send correspondence to Dr. Arfken (e-mail: carfken@med.wayne.edu). Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
authors.forename: William
authors.initials: W
authors.lastname: Drake
authors.affiliation: Dr. Amirsadri and Dr. Arfken are with the Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit. Dr. Chapman is with Gateway Community Health, Detroit. Mr. Breen and Dr. Drake are with Advanced Care, Shelby Township, Michigan. Send correspondence to Dr. Arfken (e-mail: carfken@med.wayne.edu). Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Arfken
mesh_terms: D016527:Drug Costs; D011307:Drug Prescriptions / Q000191:economics*; D016568:Drugs, Generic / Q000627:therapeutic use*; D005102:Health Expenditures; D006801:Humans; D007348:Insurance, Health / Q000191:economics*; D008603:Mental Health / Q000191:economics* / Q000331:legislation & jurisprudence*; D008824:Michigan
chemical_list: D016568:Drugs, Generic