Welcome!

News Feed Item

Exchange Plans, Medicaid Expansion Will Boost Access to Drugs for Major Depression, Bipolar Disorder and Schizophrenia

Facing Higher Costs, MCOs Will Push for Lower-Cost Treatments, According to Findings from Decision Resources Group

BURLINGTON, Mass., Sept. 3, 2014 /PRNewswire/ -- Decision Resources Group finds that surveyed managed care organizations (MCOs), psychiatrists and primary care physicians (PCPs) anticipate a significant increase in demand for drugs treating major depression, bipolar disorder and schizophrenia, owing to the expansion of Medicaid (in 24 states) and the availability of affordable coverage through the Affordable Care Act (ACA) exchanges. Among 72 surveyed psychologists, respondents expected to treat 14 percent more patients with these three indications, on average, because of coverage expansion through the ACA exchange plans and Medicaid expansion. Among 72 surveyed PCPs, the expected increase is much greater: 30 percent more patients with these conditions are expected. The 44 surveyed medical directors and pharmacy directors of MCOs indicate that the drug formularies found within the new exchange-based health plans are the same formulary or compare favorably with those of traditional group health plans. While drug classes used to treat these behavioral health conditions are widely populated with generics, MCOs offer favorable tier placement to some brands they believe to offer superior efficacy, safety and tolerability.

Decision Resources Group Logo.

Other key findings from the U.S. Physician & Payer Forum report entitled Healthcare Reform and Behavioral Health: Impact of Health Exchanges and Medicaid Expansion on Prescribing for Schizophrenia, Major Depression, and Bipolar Disorder:

  • Drug compliance: When asked to rank the most important considerations in prescribing specific drugs for behavioral disorders, surveyed psychologists and PCPs ranked patient compliance with therapy as the most important factor in prescribing.
  • Formulary placement: MCO respondents report that branded behavioral drugs such as Takeda's Brintellix, Actavis's Saphris and Novartis's Fanapt are excluded less often from exchange plans than from commercial group plans.
  • Continued demand for patient assistance programs: Surveyed PCPs and psychologists overwhelmingly support pharmaceutical companies' patient assistant programs (PAPs) and believe they will still need drug coupons for their exchange plan patients whose high deductibles or formulary exclusions are barriers.
  • Abilify: Bristol-Myers Squibb/Otsuka's Abilify is broadly used for all three indications tested here, with tier 1 or tier 2 placement in most commercial plans, on or off the exchange. Its scheduled generic launch in 2015 will likely increase its utilization, especially within Medicaid plans and in those plans where MCOs offer higher payments for physicians with high generic prescribing rates.

Comments from Decision Resources Group Principal Analyst Paula Wade:

  • "The utilization of narrow provider networks in exchange-based plans will send large numbers of new patients to primary care physicians seeking treatment for behavioral health conditions. These generalists are less familiar with the newer branded agents than psychiatrists are and might welcome additional information regarding PAPs."

About Decision Resources Group
Decision Resources Group offers best-in-class, high-value information and insights on critical issues within the healthcare industry. Clients rely on this analysis and data to make informed decisions. Find out more at www.DecisionResourcesGroup.com.

All company, brand, or product names contained in this document may be trademarks or
registered trademarks of their respective holders.

For more information, contact:

Decision Resources Group
Christopher Comfort
781-993-2597
[email protected]

Logo - http://photos.prnewswire.com/prnh/20130103/MM36768LOGO

SOURCE Decision Resources Group

More Stories By PR Newswire

Copyright © 2007 PR Newswire. All rights reserved. Republication or redistribution of PRNewswire content is expressly prohibited without the prior written consent of PRNewswire. PRNewswire shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.

Latest Stories
In his Opening Keynote at 21st Cloud Expo, John Considine, General Manager of IBM Cloud Infrastructure, led attendees through the exciting evolution of the cloud. He looked at this major disruption from the perspective of technology, business models, and what this means for enterprises of all sizes. John Considine is General Manager of Cloud Infrastructure Services at IBM. In that role he is responsible for leading IBM’s public cloud infrastructure including strategy, development, and offering m...
Recently, WebRTC has a lot of eyes from market. The use cases of WebRTC are expanding - video chat, online education, online health care etc. Not only for human-to-human communication, but also IoT use cases such as machine to human use cases can be seen recently. One of the typical use-case is remote camera monitoring. With WebRTC, people can have interoperability and flexibility for deploying monitoring service. However, the benefit of WebRTC for IoT is not only its convenience and interopera...
No hype cycles or predictions of a gazillion things here. IoT is here. You get it. You know your business and have great ideas for a business transformation strategy. What comes next? Time to make it happen. In his session at @ThingsExpo, Jay Mason, an Associate Partner of Analytics, IoT & Cybersecurity at M&S Consulting, presented a step-by-step plan to develop your technology implementation strategy. He also discussed the evaluation of communication standards and IoT messaging protocols, data...
As many know, the first generation of Cloud Management Platform (CMP) solutions were designed for managing virtual infrastructure (IaaS) and traditional applications. But that's no longer enough to satisfy evolving and complex business requirements. In his session at 21st Cloud Expo, Scott Davis, Embotics CTO, explored how next-generation CMPs ensure organizations can manage cloud-native and microservice-based application architectures, while also facilitating agile DevOps methodology. He expla...
In a recent survey, Sumo Logic surveyed 1,500 customers who employ cloud services such as Amazon Web Services (AWS), Microsoft Azure, and Google Cloud Platform (GCP). According to the survey, a quarter of the respondents have already deployed Docker containers and nearly as many (23 percent) are employing the AWS Lambda serverless computing framework. It’s clear: serverless is here to stay. The adoption does come with some needed changes, within both application development and operations. Tha...
Product connectivity goes hand and hand these days with increased use of personal data. New IoT devices are becoming more personalized than ever before. In his session at 22nd Cloud Expo | DXWorld Expo, Nicolas Fierro, CEO of MIMIR Blockchain Solutions, will discuss how in order to protect your data and privacy, IoT applications need to embrace Blockchain technology for a new level of product security never before seen - or needed.
Recently, REAN Cloud built a digital concierge for a North Carolina hospital that had observed that most patient call button questions were repetitive. In addition, the paper-based process used to measure patient health metrics was laborious, not in real-time and sometimes error-prone. In their session at 21st Cloud Expo, Sean Finnerty, Executive Director, Practice Lead, Health Care & Life Science at REAN Cloud, and Dr. S.P.T. Krishnan, Principal Architect at REAN Cloud, discussed how they built...
Sanjeev Sharma Joins June 5-7, 2018 @DevOpsSummit at @Cloud Expo New York Faculty. Sanjeev Sharma is an internationally known DevOps and Cloud Transformation thought leader, technology executive, and author. Sanjeev's industry experience includes tenures as CTO, Technical Sales leader, and Cloud Architect leader. As an IBM Distinguished Engineer, Sanjeev is recognized at the highest levels of IBM's core of technical leaders.
Nordstrom is transforming the way that they do business and the cloud is the key to enabling speed and hyper personalized customer experiences. In his session at 21st Cloud Expo, Ken Schow, VP of Engineering at Nordstrom, discussed some of the key learnings and common pitfalls of large enterprises moving to the cloud. This includes strategies around choosing a cloud provider(s), architecture, and lessons learned. In addition, he covered some of the best practices for structured team migration an...
Digital transformation is about embracing digital technologies into a company's culture to better connect with its customers, automate processes, create better tools, enter new markets, etc. Such a transformation requires continuous orchestration across teams and an environment based on open collaboration and daily experiments. In his session at 21st Cloud Expo, Alex Casalboni, Technical (Cloud) Evangelist at Cloud Academy, explored and discussed the most urgent unsolved challenges to achieve f...
SYS-CON Events announced today that Synametrics Technologies will exhibit at SYS-CON's 22nd International Cloud Expo®, which will take place on June 5-7, 2018, at the Javits Center in New York, NY. Synametrics Technologies is a privately held company based in Plainsboro, New Jersey that has been providing solutions for the developer community since 1997. Based on the success of its initial product offerings such as WinSQL, Xeams, SynaMan and Syncrify, Synametrics continues to create and hone inn...
"WineSOFT is a software company making proxy server software, which is widely used in the telecommunication industry or the content delivery networks or e-commerce," explained Jonathan Ahn, COO of WineSOFT, in this SYS-CON.tv interview at 21st Cloud Expo, held Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA.
The past few years have brought a sea change in the way applications are architected, developed, and consumed—increasing both the complexity of testing and the business impact of software failures. How can software testing professionals keep pace with modern application delivery, given the trends that impact both architectures (cloud, microservices, and APIs) and processes (DevOps, agile, and continuous delivery)? This is where continuous testing comes in. D
The dynamic nature of the cloud means that change is a constant when it comes to modern cloud-based infrastructure. Delivering modern applications to end users, therefore, is a constantly shifting challenge. Delivery automation helps IT Ops teams ensure that apps are providing an optimal end user experience over hybrid-cloud and multi-cloud environments, no matter what the current state of the infrastructure is. To employ a delivery automation strategy that reflects your business rules, making r...
There is a huge demand for responsive, real-time mobile and web experiences, but current architectural patterns do not easily accommodate applications that respond to events in real time. Common solutions using message queues or HTTP long-polling quickly lead to resiliency, scalability and development velocity challenges. In his session at 21st Cloud Expo, Ryland Degnan, a Senior Software Engineer on the Netflix Edge Platform team, will discuss how by leveraging a reactive stream-based protocol,...