title: Trends in Use and Cost of Second-Generation Antipsychotics Among Children and Teens in Indiana Medicaid, 2004-2012.
abstract: To replicate and extend a study by the Agency for Healthcare Research and Quality (AHRQ) and Rutgers on antipsychotic use among youths in Medicaid, the authors analyzed Indiana Medicaid claims from 2004 to 2012, extending the earlier study by focusing on second-generation antipsychotics, including both fee-for-service (FFS) and non-FFS patients, and analyzing cost trends.
  
  
  
  The authors evaluated the impact of several Indiana Medicaid policy changes on medication utilization and cost among children enrolled for at least one month during 2004-2012 (N=683,716-793,637), using an exhaustive antipsychotic list to search the database.
  
  
  
  Annual utilization rates for antipsychotics were 2%-3% but were much higher among foster children (10%-15%). Policies implemented in 2007 or later were associated with a significant plateauing of utilization in 2008-2012.
  
  
  
  Growth of second-generation antipsychotic utilization and costs was similar to trends described in the AHRQ-Rutgers study. Several containment strategies appeared effective in addressing these trends.
authors.affiliation: Dr. Goddard is with the Department of Psychiatry, University of California, San Francisco, Fresno (e-mail: agoddard@fresno.ucsf.edu ). Ms. Schwartz, Dr. Hendrix, Dr. Aalsma, Dr. Downs, and Dr. Rosenman are with the Department of Pediatrics, and Mr. Slaven is with the Department of Biostatistics, Indiana University School of Medicine, Indianapolis. Dr. Hancock is with the Department of Pharmacy and Mr. Lambert is with the Department of Policy, Indiana Office of Medicaid Policy and Planning, Indianapolis.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Goddard
authors.affiliation: Dr. Goddard is with the Department of Psychiatry, University of California, San Francisco, Fresno (e-mail: agoddard@fresno.ucsf.edu ). Ms. Schwartz, Dr. Hendrix, Dr. Aalsma, Dr. Downs, and Dr. Rosenman are with the Department of Pediatrics, and Mr. Slaven is with the Department of Biostatistics, Indiana University School of Medicine, Indianapolis. Dr. Hancock is with the Department of Pharmacy and Mr. Lambert is with the Department of Policy, Indiana Office of Medicaid Policy and Planning, Indianapolis.
authors.forename: Katherine
authors.initials: K
authors.lastname: Schwartz
authors.affiliation: Dr. Goddard is with the Department of Psychiatry, University of California, San Francisco, Fresno (e-mail: agoddard@fresno.ucsf.edu ). Ms. Schwartz, Dr. Hendrix, Dr. Aalsma, Dr. Downs, and Dr. Rosenman are with the Department of Pediatrics, and Mr. Slaven is with the Department of Biostatistics, Indiana University School of Medicine, Indianapolis. Dr. Hancock is with the Department of Pharmacy and Mr. Lambert is with the Department of Policy, Indiana Office of Medicaid Policy and Planning, Indianapolis.
authors.forename: Kristin
authors.initials: K
authors.lastname: Hendrix
authors.affiliation: Dr. Goddard is with the Department of Psychiatry, University of California, San Francisco, Fresno (e-mail: agoddard@fresno.ucsf.edu ). Ms. Schwartz, Dr. Hendrix, Dr. Aalsma, Dr. Downs, and Dr. Rosenman are with the Department of Pediatrics, and Mr. Slaven is with the Department of Biostatistics, Indiana University School of Medicine, Indianapolis. Dr. Hancock is with the Department of Pharmacy and Mr. Lambert is with the Department of Policy, Indiana Office of Medicaid Policy and Planning, Indianapolis.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Aalsma
authors.affiliation: Dr. Goddard is with the Department of Psychiatry, University of California, San Francisco, Fresno (e-mail: agoddard@fresno.ucsf.edu ). Ms. Schwartz, Dr. Hendrix, Dr. Aalsma, Dr. Downs, and Dr. Rosenman are with the Department of Pediatrics, and Mr. Slaven is with the Department of Biostatistics, Indiana University School of Medicine, Indianapolis. Dr. Hancock is with the Department of Pharmacy and Mr. Lambert is with the Department of Policy, Indiana Office of Medicaid Policy and Planning, Indianapolis.
authors.forename: James
authors.initials: J
authors.lastname: Slaven
authors.affiliation: Dr. Goddard is with the Department of Psychiatry, University of California, San Francisco, Fresno (e-mail: agoddard@fresno.ucsf.edu ). Ms. Schwartz, Dr. Hendrix, Dr. Aalsma, Dr. Downs, and Dr. Rosenman are with the Department of Pediatrics, and Mr. Slaven is with the Department of Biostatistics, Indiana University School of Medicine, Indianapolis. Dr. Hancock is with the Department of Pharmacy and Mr. Lambert is with the Department of Policy, Indiana Office of Medicaid Policy and Planning, Indianapolis.
authors.forename: Emily F
authors.initials: EF
authors.lastname: Hancock
authors.affiliation: Dr. Goddard is with the Department of Psychiatry, University of California, San Francisco, Fresno (e-mail: agoddard@fresno.ucsf.edu ). Ms. Schwartz, Dr. Hendrix, Dr. Aalsma, Dr. Downs, and Dr. Rosenman are with the Department of Pediatrics, and Mr. Slaven is with the Department of Biostatistics, Indiana University School of Medicine, Indianapolis. Dr. Hancock is with the Department of Pharmacy and Mr. Lambert is with the Department of Policy, Indiana Office of Medicaid Policy and Planning, Indianapolis.
authors.forename: David
authors.initials: D
authors.lastname: Lambert
authors.affiliation: Dr. Goddard is with the Department of Psychiatry, University of California, San Francisco, Fresno (e-mail: agoddard@fresno.ucsf.edu ). Ms. Schwartz, Dr. Hendrix, Dr. Aalsma, Dr. Downs, and Dr. Rosenman are with the Department of Pediatrics, and Mr. Slaven is with the Department of Biostatistics, Indiana University School of Medicine, Indianapolis. Dr. Hancock is with the Department of Pharmacy and Mr. Lambert is with the Department of Policy, Indiana Office of Medicaid Policy and Planning, Indianapolis.
authors.forename: Stephen
authors.initials: S
authors.lastname: Downs
authors.affiliation: Dr. Goddard is with the Department of Psychiatry, University of California, San Francisco, Fresno (e-mail: agoddard@fresno.ucsf.edu ). Ms. Schwartz, Dr. Hendrix, Dr. Aalsma, Dr. Downs, and Dr. Rosenman are with the Department of Pediatrics, and Mr. Slaven is with the Department of Biostatistics, Indiana University School of Medicine, Indianapolis. Dr. Hancock is with the Department of Pharmacy and Mr. Lambert is with the Department of Policy, Indiana Office of Medicaid Policy and Planning, Indianapolis.
authors.forename: Marc
authors.initials: M
authors.lastname: Rosenman
mesh_terms: D000293:Adolescent; D014150:Antipsychotic Agents / Q000191:economics* / Q000627:therapeutic use*; D002648:Child; D005260:Female; D006801:Humans; D007196:Indiana / Q000453:epidemiology; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
chemical_list: D014150:Antipsychotic Agents