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
Smart Cities are here to stay, but for their promise to be delivered, the data they produce must not be put in new siloes. In his session at @ThingsExpo, Mathias Herberts, Co-founder and CTO of Cityzen Data, will deep dive into best practices that will ensure a successful smart city journey.
SYS-CON Events announced today that 910Telecom will exhibit at the 19th International Cloud Expo, which will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. Housed in the classic Denver Gas & Electric Building, 910 15th St., 910Telecom is a carrier-neutral telecom hotel located in the heart of Denver. Adjacent to CenturyLink, AT&T, and Denver Main, 910Telecom offers connectivity to all major carriers, Internet service providers, Internet backbones and ...
SYS-CON Events announced today that eCube Systems, a leading provider of middleware modernization, integration, and management solutions, will exhibit at @DevOpsSummit at 19th International Cloud Expo, which will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. eCube Systems offers a family of middleware evolution products and services that maximize return on technology investment by leveraging existing technical equity to meet evolving business needs. ...
DevOps at Cloud Expo – being held November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA – announces that its Call for Papers is open. Born out of proven success in agile development, cloud computing, and process automation, DevOps is a macro trend you cannot afford to miss. From showcase success stories from early adopters and web-scale businesses, DevOps is expanding to organizations of all sizes, including the world's largest enterprises – and delivering real results. Am...
Pulzze Systems was happy to participate in such a premier event and thankful to be receiving the winning investment and global network support from G-Startup Worldwide. It is an exciting time for Pulzze to showcase the effectiveness of innovative technologies and enable them to make the world smarter and better. The reputable contest is held to identify promising startups around the globe that are assured to change the world through their innovative products and disruptive technologies. There w...
Internet of @ThingsExpo, taking place November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA, is co-located with 19th Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry players in the world. The Internet of Things (IoT) is the most profound change in personal and enterprise IT since the creation of the Worldwide Web more than 20 years ago. All major researchers estimate there will be tens of billions devices - comp...
DevOps at Cloud Expo, taking place Nov 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA, is co-located with 19th Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry players in the world. The widespread success of cloud computing is driving the DevOps revolution in enterprise IT. Now as never before, development teams must communicate and collaborate in a dynamic, 24/7/365 environment. There is no time to wait for long dev...
SYS-CON Events announced today that StarNet Communications will exhibit at the 19th International Cloud Expo, which will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. StarNet Communications’ FastX is the industry first cloud-based remote X Windows emulator. Using standard Web browsers (FireFox, Chrome, Safari, etc.) users from around the world gain highly secure access to applications and data hosted on Linux-based servers in a central data center. ...
Traditional on-premises data centers have long been the domain of modern data platforms like Apache Hadoop, meaning companies who build their business on public cloud were challenged to run Big Data processing and analytics at scale. But recent advancements in Hadoop performance, security, and most importantly cloud-native integrations, are giving organizations the ability to truly gain value from all their data. In his session at 19th Cloud Expo, David Tishgart, Director of Product Marketing ...
Data is the fuel that drives the machine learning algorithmic engines and ultimately provides the business value. In his session at Cloud Expo, Ed Featherston, a director and senior enterprise architect at Collaborative Consulting, will discuss the key considerations around quality, volume, timeliness, and pedigree that must be dealt with in order to properly fuel that engine.
There is growing need for data-driven applications and the need for digital platforms to build these apps. In his session at 19th Cloud Expo, Muddu Sudhakar, VP and GM of Security & IoT at Splunk, will cover different PaaS solutions and Big Data platforms that are available to build applications. In addition, AI and machine learning are creating new requirements that developers need in the building of next-gen apps. The next-generation digital platforms have some of the past platform needs a...
19th Cloud Expo, taking place November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA, will feature technical sessions from a rock star conference faculty and the leading industry players in the world. Cloud computing is now being embraced by a majority of enterprises of all sizes. Yesterday's debate about public vs. private has transformed into the reality of hybrid cloud: a recent survey shows that 74% of enterprises have a hybrid cloud strategy. Meanwhile, 94% of enterpri...
SYS-CON Events announced today Telecom Reseller has been named “Media Sponsor” of SYS-CON's 19th International Cloud Expo, which will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. Telecom Reseller reports on Unified Communications, UCaaS, BPaaS for enterprise and SMBs. They report extensively on both customer premises based solutions such as IP-PBX as well as cloud based and hosted platforms.
The 19th International Cloud Expo has announced that its Call for Papers is open. Cloud Expo, to be held November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA, brings together Cloud Computing, Big Data, Internet of Things, DevOps, Digital Transformation, Microservices and WebRTC to one location. With cloud computing driving a higher percentage of enterprise IT budgets every year, it becomes increasingly important to plant your flag in this fast-expanding business opportuni...
As the world moves toward more DevOps and Microservices, application deployment to the cloud ought to become a lot simpler. The Microservices architecture, which is the basis of many new age distributed systems such as OpenStack, NetFlix and so on, is at the heart of Cloud Foundry - a complete developer-oriented Platform as a Service (PaaS) that is IaaS agnostic and supports vCloud, OpenStack and AWS. Serverless computing is revolutionizing computing. In his session at 19th Cloud Expo, Raghav...