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Pitt study examines cost-effectiveness of medicare drug plans in schizophrenia and bipolar disorder
Date:2/20/2013

PITTSBURGH, Feb. 19, 2013 A new study published online today in the American Journal of Managed Care found that in Medicare Part D, generic drug coverage was cost-saving compared to no coverage in bipolar disorder and schizophrenia, while also improving health outcomes. Researchers from the University of Pittsburgh School of Medicine, the Pitt Graduate School of Public Health, and Western Psychiatric Institute and Clinic of UPMC note that policymakers and insurers should consider generic-only coverage, rather than no gap coverage, to both conserve health care resources and improve health.

Medicare Part D offers prescription drug coverage for Medicare beneficiaries and since the program's inception in 2006, many enrollees have benefited from improved drug coverage and increased medication use. However, a major concern is the large coverage gap in the standard Part D design, where beneficiaries pay 100 percent of medication costs out-of-pocket. About one-third of all Medicare beneficiaries enter this coverage gap each year, and once there, they often reduce medication use, which may lead to increases in hospitalization and medical spending.

"This coverage gap is an even larger concern for Medicare beneficiaries with severe mental disorders such as bipolar and schizophrenia," said Kenneth J. Smith, M.D., M.S., associate professor of medicine and clinical and translational science at the University of Pittsburgh, and lead author of the study. "Our cost-effectiveness analysis of Part D plans is an unconventional yet instructive way to inform managed care decision-making."

Added concerns for mental health patients include:

  • Mental health patients are much more likely to enter the "gap:" 62 percent of Medicare beneficiaries with bipolar disorder and 56 percent of those with schizophrenia entered the gap in 2007.

  • If they discontinue psychotropic medications, they may relapse to more severe episodes and requ
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Contact: Cristina Mestre
MestreCA@upmc.edu
412-586-9776
University of Pittsburgh Schools of the Health Sciences
Source:Eurekalert

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