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1.
Adm Policy Ment Health ; 43(4): 497-505, 2016 07.
Artículo en Inglés | MEDLINE | ID: mdl-26041078

RESUMEN

Spending on psychotropic medications has grown rapidly in recent decades. Using national data on drug expenditures, patent expirations, future drug development and expert interviews, we project that spending will grow more slowly over the period 2012-2020. The average annual increase is projected to be just 3.0 % per year, continuing the steady deceleration in recent years. The main drivers of this expected deceleration include slower development of new drugs, upcoming patent expirations which will lower prices, and payers' growing ability to manage utilization and promote generic use. The slowdown will relieve some cost pressures on payers, particularly Medicare and Medicaid.


Asunto(s)
Gastos en Salud , Psicotrópicos/economía , Descubrimiento de Drogas , Medicamentos Genéricos/economía , Predicción , Humanos , Medicaid , Medicare , Patentes como Asunto , Estados Unidos
2.
Eval Rev ; 33(2): 103-37, 2009 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-19126788

RESUMEN

We reviewed 39 national government- and nongovernment-sponsored data sets related to substance addiction policy. These data sets describe patients with substance use disorders (SUDs), treatment providers and the services they offer, and/or expenditures on treatment. Findings indicate the availability of reliable data on the prevalence of SUD and the characteristics of specialty treatment facilities, but meager data on financing and services. Gaps in information might be filled through agency collaboration to redesign, coordinate, and augment existing substance abuse and general health surveys. Despite noted gaps, these data sets represent an unusually rich set of resources for health services and policy research.


Asunto(s)
Práctica Clínica Basada en la Evidencia/estadística & datos numéricos , Política de Salud , Investigación sobre Servicios de Salud/estadística & datos numéricos , Centros de Tratamiento de Abuso de Sustancias/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología , Bases de Datos Factuales , Humanos , Trastornos Relacionados con Sustancias/prevención & control , Estados Unidos
3.
Med Care Res Rev ; 75(4): 434-453, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29148332

RESUMEN

Medicare Advantage plans have incentives and tools to optimize patient care. Therefore, Medicare Advantage hospitalizations may have lower cost and higher quality than similar traditional Medicare hospitalizations. We applied a coarsened matching approach to 2013 Healthcare Cost and Utilization Project hospital discharge data from 22 states to compare hospital cost, length of stay, and readmissions for Traditional Medicare and Medicare Advantage. We found that Medicare Advantage hospitalizations were substantially less expensive and shorter for mental health stays but costlier and longer for injury and surgical stays. We found little difference in the cost and length of medical stays and in readmission rates. One explanation is that Medicare Advantage plans use outpatient settings for many patients with behavioral health conditions and for injury and surgical patients with less complex health needs. Alternatively, the observed differences in behavioral health cost and length of stay may represent skimping on appropriate care.


Asunto(s)
Costos de la Atención en Salud/estadística & datos numéricos , Costos de Hospital/estadística & datos numéricos , Hospitalización/economía , Tiempo de Internación/economía , Medicare Part C/economía , Medicare/economía , Readmisión del Paciente/economía , Anciano , Anciano de 80 o más Años , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Medicare/estadística & datos numéricos , Medicare Part C/estadística & datos numéricos , Readmisión del Paciente/estadística & datos numéricos , Estados Unidos
4.
Psychiatr Serv ; 58(8): 1041-8, 2007 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-17664514

RESUMEN

OBJECTIVE: This study determined spending on mental health treatment in the United States over time by provider and payer relative to all health spending. METHODS: Estimates were developed to be consistent with the National Health Expenditure Accounts. Numerous public data sources were used. RESULTS: Mental health treatment expenditures grew from $33 billion in 1986 to $100 billion in 2003. In real 2003 dollars, spending per capita on mental health treatment rose from $205 to $345. The average annual nominal total mental health growth rate was 6.7%. In comparison, total health care expenditures increased by 8.0%. As a result of the slower growth rate of mental health expenditures compared with all health spending, mental health fell from 8% of all health expenditures in 1986 to 6% in 2003. Total national health spending increased by approximately $1.175 trillion from 1986 to 2003; of this, 6% is attributed to an increase in mental health spending. The mix of services has changed, with more care being provided through prescription drugs and in outpatient settings and less in inpatient settings. Payer mix has also shifted, with Medicaid taking a more prominent role. CONCLUSIONS: Spending on mental health treatment has increased over the past decade, reflecting increases in the number of individuals receiving mental health treatment, particularly prescription drugs and outpatient treatment. Changes in payer and provider mix raise new challenges for ensuring quality and access.


Asunto(s)
Gastos en Salud/tendencias , Trastornos Mentales/economía , Servicios de Salud Mental/economía , Atención a la Salud/economía , Costos de los Medicamentos/tendencias , Financiación Personal/economía , Accesibilidad a los Servicios de Salud/economía , Hospitalización/economía , Humanos , Cobertura del Seguro/economía , Seguro Psiquiátrico/economía , Medicaid/economía , Trastornos Mentales/rehabilitación , Psicotrópicos/economía , Estados Unidos
5.
Psychiatr Serv ; 67(5): 504-9, 2016 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-26725293

RESUMEN

OBJECTIVE: Recessions are associated with increased prevalence of mental and substance use disorders, but their effect on use of behavioral health services is less clear. This study examined changes in spending per enrollee for behavioral health services compared with general medical services among individuals with private insurance following the Great Recession that began in 2007. METHODS: The National Survey on Drug Use and Health was used to examine the prevalence of behavioral health conditions among persons with private insurance from 2004 to 2013. Truven Health MarketScan Commercial Claims and Encounters data (2004-2012) were used to calculate use of and spending on treatment of behavioral and general medical conditions before and after the recession among individuals with employer-sponsored private health insurance. RESULTS: There was a statistically significant increase in serious psychological distress and episodes of major depression between 2007 and 2010. Between 2004-2009 and 2009-2012, the growth in average annual spending per individual slowed for general medical care (from 6.6% to 3.7%) but accelerated for behavioral health care (from 4.8% to 6.6%). From 2009 to 2012, the percentage of individuals receiving inpatient treatment, outpatient treatment, and prescription drugs for behavioral conditions increased, whereas use of these services for general medical care decreased or remained flat. Out-of-pocket costs increased more slowly for behavioral conditions than for other medical conditions. CONCLUSIONS: The recession was associated with increased need for and use of behavioral health services among individuals with private insurance. The Mental Health Parity and Addiction Equity Act may have also played a role in facilitating increasing use of behavioral health services after 2008.


Asunto(s)
Terapia Conductista/economía , Gastos en Salud/tendencias , Trastornos Mentales/epidemiología , Servicios de Salud Mental/tendencias , Trastornos Relacionados con Sustancias/epidemiología , Adolescente , Adulto , Anciano , Atención Ambulatoria/tendencias , Niño , Bases de Datos Factuales , Utilización de Medicamentos/tendencias , Recesión Económica , Femenino , Hospitalización/tendencias , Humanos , Revisión de Utilización de Seguros , Seguro de Salud/economía , Masculino , Trastornos Mentales/economía , Trastornos Mentales/terapia , Servicios de Salud Mental/estadística & datos numéricos , Persona de Mediana Edad , Trastornos Relacionados con Sustancias/economía , Trastornos Relacionados con Sustancias/terapia , Estados Unidos , Adulto Joven
6.
Drug Alcohol Depend ; 160: 143-50, 2016 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-26781063

RESUMEN

BACKGROUND: Approximately 8% of individuals with private health insurance in the United States have substance use disorders (SUDs), but in 2009 only 0.4% of all private insurance spending was on SUDs. The objective of this study was to determine if changes that occurred between 2009 and 2012 - such as more generous SUD benefits, an epidemic of opioid use disorders, and slow recovery from a recession - were associated with greater use of SUD treatment. METHODS: Data were from the 2004-2012 Truven Health Analytics MarketScan(®) Commercial Claims and Encounters Database. This database is representative of individuals with private insurance in the United States. Per enrollee use of and spending on SUD treatment was determined and compared with spending on all health care services. Trends were examined for inpatient care, outpatient care, and prescription medications. RESULTS: During the 2009-2012 time period, use of and spending on SUD services increased compared with all diagnoses. Two-thirds of the increase was driven by higher growth rates in outpatient use and prices. Despite the high growth rates, SUD treatment penetration rates remained low. As of 2012, only 0.6% of individuals with private insurance used SUD outpatient services, 0.2% filled SUD medication prescriptions, and 0.1% used inpatient SUD services. In 2012, SUD services accounted for less than 0.7% of all private insurance spending. CONCLUSIONS: Despite recent coverage improvements, individuals with private health insurance still may not receive adequate levels of treatment for SUDs, as evidenced by the small proportion of individuals who access treatment.


Asunto(s)
Gastos en Salud/tendencias , Seguro de Salud/economía , Sector Privado/economía , Trastornos Relacionados con Sustancias/economía , Adulto , Atención Ambulatoria/economía , Prescripciones de Medicamentos/economía , Femenino , Hospitalización/economía , Humanos , Masculino , Servicios de Salud Mental/economía , Persona de Mediana Edad , Centros de Tratamiento de Abuso de Sustancias/economía , Trastornos Relacionados con Sustancias/terapia , Estados Unidos
7.
Health Aff (Millwood) ; 35(6): 958-65, 2016 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-27269010

RESUMEN

This study updates previous estimates of US spending on mental health and substance use disorders through 2014. The results reveal that the long-term trend of greater insurance financing of mental health care continued in recent years. The share of total mental health treatment expenditures financed by private insurance, Medicare, and Medicaid increased from 44 percent in 1986 to 68 percent in 2014. In contrast, the share of spending for substance use disorder treatment financed by private insurance, Medicare, and Medicaid was 45 percent in 1986 and 46 percent in 2014. From 2004 to 2013, a growing percentage of adults received mental health treatment (12.6 percent and 14.6 percent, respectively), albeit only because of the increased use of psychiatric medications. In the same period, only 1.2-1.3 percent of adults received substance use disorder treatment in inpatient, outpatient, or residential settings, although the use of medications to treat substance use disorders increased rapidly.


Asunto(s)
Gastos en Salud/estadística & datos numéricos , Seguro de Salud/tendencias , Servicios de Salud Mental/economía , Servicios de Salud Mental/tendencias , Trastornos Relacionados con Sustancias/economía , Financiación Gubernamental/economía , Humanos , Seguro de Salud/economía , Medicaid/estadística & datos numéricos , Medicare/estadística & datos numéricos , Trastornos Mentales/tratamiento farmacológico , Estados Unidos
8.
Health Aff (Millwood) ; 23(1): 147-59, 2004.
Artículo en Inglés | MEDLINE | ID: mdl-15002637

RESUMEN

U.S. health care spending climbed to dollars 1.6 trillion in 2002, or dollars 5,440 per person. Health spending rose 8.5 percent in 2001 and 9.3 percent in 2002, contributing to a spike of 1.6 percentage points in the health share of gross domestic product (GDP) since 2000. Hospital spending accounted for nearly a third of the aggregate increase. During the past three decades, per enrollee spending for a common benefit package has grown at a slightly slower average annual rate for Medicare than for private health insurance, with more pronounced growth differences recently reflecting legislated Medicare reimbursement changes and consumers' calls for more loosely managed care.


Asunto(s)
Economía Hospitalaria , Gastos en Salud/tendencias , Gastos en Salud/estadística & datos numéricos , Seguro de Salud/economía , Medicaid/economía , Medicaid/estadística & datos numéricos , Medicare/economía , Medicare/estadística & datos numéricos , Estados Unidos
9.
Health Aff (Millwood) ; 21(4): 112-26, 2002.
Artículo en Inglés | MEDLINE | ID: mdl-12117122

RESUMEN

Health care spending varies considerably across states. Spending per person ranged from $2,731 in Utah to $4,810 in Massachusetts in 1998, with Medicaid's share of total health care spending rangingfrom 9.1 percent in Nevada to 31.5 percent in New York. Research has suggested many reasons for such differences, including socioeconomic and demographic factors, market forces, and diversity in practice patterns. By using consistent methodologies among states, these 1991-1998 estimates, last produced for 1991 alone, will further the understanding of these differences.


Asunto(s)
Gastos en Salud/tendencias , Atención Individual de Salud/economía , Control de Costos , Humanos , Medicaid/economía , Medicaid/estadística & datos numéricos , Medicare/economía , Medicare/estadística & datos numéricos , Atención Individual de Salud/estadística & datos numéricos , Calidad de la Atención de Salud , Estados Unidos
10.
Health Aff (Millwood) ; 22(1): 154-64, 2003.
Artículo en Inglés | MEDLINE | ID: mdl-12528847

RESUMEN

U.S. health care spending grew 8.7 percent to $5,035 per capita in 2001. Total public funding continued to accelerate, increasing 9.4 percent and exceeding private funding growth by 1.2 percentage points. This acceleration was due in part to increased Medicaid spending in the midst of a recession and payment increases for Medicare providers. Prompted by sluggish economic growth and by faster-paced health spending, health spending's share of GDP spiked 0.8 percentage points in 2001 to 14.1 percent.


Asunto(s)
Gastos en Salud/tendencias , Medicaid/economía , Planes Estatales de Salud/economía , Análisis Actuarial , Centers for Medicare and Medicaid Services, U.S. , Recolección de Datos , Gastos en Salud/clasificación , Gastos en Salud/estadística & datos numéricos , Humanos , Medicaid/estadística & datos numéricos , Planes Estatales de Salud/estadística & datos numéricos , Estados Unidos
11.
Health Care Financ Rev ; 23(3): 115-30, 2002.
Artículo en Inglés | MEDLINE | ID: mdl-12500352

RESUMEN

Employer-sponsored health insurance accounts for almost one-third of all health care spending. As health care cost growth accelerates affecting the availability of employer-sponsored insurance and depth of coverage, the importance of timely and accurate information for measuring and monitoring these changes and formulating policy options increases. Identifying a growing gap between the need for and availability of data to inform policy on employment-related health insurance issues, the Office of Management and Budget (OMB) established a committee of Federal agency representatives to evaluate and advise data collection efforts. This article reports on the committee's current efforts, focusing on evaluation of results from the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC) and the National Compensation Survey (NCS).


Asunto(s)
Recolección de Datos/métodos , Agencias Gubernamentales , Planes de Asistencia Médica para Empleados/estadística & datos numéricos , Servicios de Información/organización & administración , Acceso a la Información , Costos de Salud para el Patrón , Honorarios y Precios , Planes de Asistencia Médica para Empleados/economía , Planes de Asistencia Médica para Empleados/tendencias , Gastos en Salud/estadística & datos numéricos , Humanos , Sector Privado , Estados Unidos
12.
Health Care Financ Rev ; 14(3): 249-281, 1993.
Artículo en Inglés | MEDLINE | ID: mdl-25372467

RESUMEN

This regular feature of the journal includes a discussion of each of the following four topics community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they allow us to anticipate the direction and magnitude of health care cost changes prior to the availability of more comprehensive data.

13.
Health Care Financ Rev ; 23(3): 131-59, 2002.
Artículo en Inglés | MEDLINE | ID: mdl-12500353

RESUMEN

In this article, we estimate expenditures by businesses, households, and governments in providing financing for health care for 1987-2000 and track measures of burden that these costs impose. Although burden measures for businesses and the Federal Government have stabilized or improved since 1993, measures of burden for State and local governments are deteriorating slightly--a situation that is likely to worsen in the near future. As health care spending accelerates and an economy wide recession seems imminent, businesses, households, and governments that finance health care will face renewed health cost pressures on their revenue and income.


Asunto(s)
Costo de Enfermedad , Costos de la Atención en Salud/estadística & datos numéricos , Gastos en Salud/estadística & datos numéricos , Recolección de Datos , Costos de Salud para el Patrón/estadística & datos numéricos , Costos de Salud para el Patrón/tendencias , Composición Familiar , Financiación Gubernamental/clasificación , Financiación Gubernamental/estadística & datos numéricos , Financiación Gubernamental/tendencias , Costos de la Atención en Salud/tendencias , Gastos en Salud/clasificación , Gastos en Salud/tendencias , Investigación sobre Servicios de Salud , Humanos , Estados Unidos , Indemnización para Trabajadores/estadística & datos numéricos
14.
Health Aff (Millwood) ; 33(8): 1407-15, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25092843

RESUMEN

Spending on mental and substance use disorders will likely grow more slowly than all health spending through 2020. We project that spending on mental and substance use disorders, as a share of all health spending, will fall from 7.4 percent in 2009 ($172 billion out of $2.3 trillion) to 6.5 percent in 2020 ($281 billion out of $4.3 trillion). This trend is the projected result of reduced spending on mental health drugs because of patent expirations, the low likelihood of innovative drugs entering the market, and a slowdown in spending growth for hospital treatment. By 2020 the expansion of coverage to previously uninsured Americans under the Affordable Care Act (ACA), combined with the projected slowdown in Medicare provider payment rates under the ACA and the Budget Control Act of 2011, are expected to add 2.7 percent to behavioral health spending, compared to spending without these changes.


Asunto(s)
Gastos en Salud/tendencias , Trastornos Mentales/economía , Trastornos Relacionados con Sustancias/economía , Predicción , Humanos , Medicare/economía , Trastornos Mentales/terapia , Modelos Estadísticos , Patient Protection and Affordable Care Act , Estados Unidos
15.
Psychiatr Serv ; 65(12): 1433-8, 2014 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-25178309

RESUMEN

OBJECTIVE: Psychotropic drug development is perceived to be lagging behind other pharmaceutical development, even though there is a need for more effective psychotropic medications. This study examined the state of the current psychotropic drug pipeline and potential barriers to psychotropic drug development. METHODS: The authors scanned the recent academic and "grey" literature to evaluate psychotropic drug development and to identify experts in the fields of psychiatry and substance use disorder treatment and psychotropic drug development. On the basis of that preliminary research, the authors interviewed six experts and analyzed drugs being studied for treatment of major psychiatric disorders in phase III clinical trials. RESULTS: Interviews and review of clinical trials of drugs in phase III of development confirmed that the psychotropic pipeline is slim and that a majority of the drugs in phase III trials are not very innovative. Among the barriers to development are incentives that encourage firms to focus on incremental innovation rather than take risks on radically new approaches. Other barriers include human brain complexity, failure of animal trials to translate well to human trials, and a drug approval threshold that is perceived as so high that it discourages development. CONCLUSIONS: Drivers of innovation in psychotropic drug development largely parallel those for other drugs, yet crucial distinctions have led to slowing psychotropic development after a period of innovation and growth. Various factors have acted to dry up the pipeline for psychotropic drugs, with expert opinion suggesting that in the near term, this trend is likely to continue.


Asunto(s)
Descubrimiento de Drogas/métodos , Trastornos Mentales/tratamiento farmacológico , Psicotrópicos/farmacología , Ensayos Clínicos Fase III como Asunto , Humanos , Salud Mental , Terapias en Investigación/métodos
16.
Health Serv Res ; 48(5): 1779-97, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23662642

RESUMEN

OBJECTIVE: To develop a tool for estimating hospital-specific inpatient prices for major payers. DATA SOURCES: AHRQ Healthcare Cost and Utilization Project State Inpatient Databases and complete hospital financial reporting of revenues mandated in 10 states for 2006. STUDY DESIGN: Hospital discharge records and hospital financial information were merged to estimate revenue per stay by payer. Estimated prices were validated against other data sources. PRINCIPAL FINDINGS: Hospital prices can be reasonably estimated for 10 geographically diverse states. All-payer price-to-charge ratios, an intermediate step in estimating prices, compare favorably to cost-to-charge ratios. Estimated prices also compare well with Medicare, MarketScan private insurance, and the Medical Expenditure Panel Survey prices for major payers, given limitations of each dataset. CONCLUSIONS: Public reporting of prices is a consumer resource in making decisions about health care treatment; for self-pay patients, they can provide leverage in negotiating discounts off of charges. Researchers can also use prices to increase understanding of the level and causes of price differentials among geographic areas. Prices by payer expand investigational tools available to study the interaction of inpatient hospital price setting among public and private payers--an important asset as the payer mix changes with the implementation of the Affordable Care Act.


Asunto(s)
Costos de Hospital/estadística & datos numéricos , Pacientes Internos/estadística & datos numéricos , Modelos Estadísticos , Investigación sobre Servicios de Salud , Humanos , Tiempo de Internación/economía , Medicaid/economía , Medicare/economía , Patient Protection and Affordable Care Act , Estados Unidos
17.
Health Aff (Millwood) ; 32(5): 952-62, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23650330

RESUMEN

The 2007-09 recession had a dramatic effect on behavioral health spending, with the effect most prominent for private, state, and local payers. During the recession behavioral health spending increased at a 4.6 percent average annual rate, down from 6.1 percent in 2004-07. Average annual growth in private behavioral health spending during the recession slowed to 2.7 percent from 7.2 percent in 2004-07. State and local behavioral health spending showed negative average annual growth, -1.2 percent, during the recession, compared with 3.7 percent increases in 2004-07. In contrast, federal behavioral health spending growth accelerated to 11.1 percent during the recession, up from 7.2 percent in 2004-07. These behavioral health spending trends were driven largely by increased federal spending in Medicaid, declining private insurance enrollment, and severe state budget constraints. An increased federal Medicaid match reduced the state share of Medicaid spending, which prevented more drastic cuts in state-funded behavioral health programs during the recession. Federal Medicaid served as a critical safety net for people with behavioral health treatment needs during the recession.


Asunto(s)
Recesión Económica/estadística & datos numéricos , Financiación Gubernamental/estadística & datos numéricos , Planes de Asistencia Médica para Empleados/estadística & datos numéricos , Gastos en Salud/estadística & datos numéricos , Servicios de Salud Mental/economía , Financiación Gubernamental/economía , Planes de Asistencia Médica para Empleados/economía , Costos de la Atención en Salud/estadística & datos numéricos , Humanos , Seguro de Salud/economía , Seguro de Salud/estadística & datos numéricos , Medicaid/economía , Medicaid/estadística & datos numéricos , Servicios de Salud Mental/estadística & datos numéricos , Trastornos Relacionados con Sustancias/economía , Trastornos Relacionados con Sustancias/terapia , Estados Unidos
18.
Psychiatr Serv ; 64(6): 512-9, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23450375

RESUMEN

OBJECTIVES: Goals were to describe funding for specialty behavioral health providers in 1986 and 2005 and examine how the recession, parity law, and Affordable Care Act (ACA) may affect future funding. METHODS: Numerous public data sets and actuarial methods were used to estimate spending for services from specialty behavioral health providers (general hospital specialty units; specialty hospitals; psychiatrists; other behavioral health professionals; and specialty mental health and substance abuse treatment centers). RESULTS: Between 1986 and 2005, hospitals-which had received the largest share of behavioral health spending-declined in importance, and spending shares trended away from specialty hospitals that were largely funded by state and local governments. Hospitals' share of funding from private insurance decreased from 25% in 1986 to 12% in 2005, and the Medicaid share increased from 11% to 23%. Office-based specialty providers continued to be largely dependent on private insurance and out-of-pocket payments, with psychiatrists receiving increased Medicaid funding. Specialty centers received increased funding shares from Medicaid (from 11% to 29%), and shares from other state and local government sources fell (from 64% to 46%). CONCLUSIONS: With ACA's full implementation, spending on behavioral health will likely increase under private insurance and Medicaid. Parity in private plans will also push a larger share of payments for office-based professionals from out-of-pocket payments to private insurance. As ACA provides insurance for formerly uninsured individuals, funding by state behavioral health authorities of center-based treatment will likely refocus on recovery and support services. Federal Medicaid rules will increase in importance as more people needing behavioral health treatment become covered.


Asunto(s)
Organización de la Financiación/economía , Servicios de Salud Mental/economía , Centros de Tratamiento de Abuso de Sustancias/economía , Financiación Gubernamental/economía , Humanos , Medicaid/economía , Patient Protection and Affordable Care Act/economía , Estados Unidos
19.
Psychiatr Serv ; 63(1): 13-8, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22227754

RESUMEN

OBJECTIVE: This study analyzed recent trends in spending on psychiatric prescription drugs and underlying factors that served as drivers of these changes. METHODS: Data were collected from the MarketScan Commercial Claims and Encounters Database (1997-2008), Substance Abuse and Mental Health Services Administration spending estimates (1986-2005), and the Medical Expenditure Panel Survey (1997-2007). The trends in medication spending derived from the data were decomposed into three categories: percentage of enrollees who used psychiatric medications, days supplied per user, and cost per day supplied. RESULTS: The average annual rate of growth in expenditures per enrollee slowed from 18.5% in 1997-2001 to 6.3% in 2001-2008. A decline in the growth rate of cost per day supplied, from 8% to 2%, accounted for 49% of the overall decline in spending growth, and a decline in the growth of the percentage of enrollees who used medication, from 7% to 2%, contributed 41% to the overall decline. There was a smaller change in days supplied per user, from 3% to 2%, that contributed 10% to the overall decline. The increased entry of generic medications, which constituted 70% of all psychiatric prescriptions by 2008, particularly generic antidepressants, was a key contributor to the slower growth in costs. CONCLUSIONS: Past high growth in psychiatric drug spending arising from growth in utilization of branded medications has declined significantly, which may have implications for access and new product investment.


Asunto(s)
Utilización de Medicamentos/tendencias , Gastos en Salud/tendencias , Trastornos Mentales/tratamiento farmacológico , Psicotrópicos/economía , Costos de los Medicamentos/tendencias , Prescripciones de Medicamentos/estadística & datos numéricos , Medicamentos Genéricos/economía , Encuestas de Atención de la Salud , Humanos , Medicamentos bajo Prescripción/economía , Estados Unidos
20.
Health Aff (Millwood) ; 30(2): 284-92, 2011 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-21289350

RESUMEN

The United States invests a sizable amount of money on treatments for mental health and substance abuse: $135 billion in 2005, or 1.07 percent of the gross domestic product. We provide treatment spending estimates from the period 1986-2005 to build understanding of past trends and consider future possibilities. We find that the growth rate in spending on mental health medications-a major driver of mental health expenditures in prior years-declined dramatically. As a result, mental health and substance abuse spending grew at a slightly slower rate than gross domestic product in 2004 and 2005, and it continued to shrink as a share of all health spending. Of note, we also find that Medicaid's share of total spending on mental health grew from 17 percent in 1986 to 27 percent in 2002 to 28 percent in 2005. The recent recession, the full implementation of federal parity law, and such health reform-related actions as the planned expansion of Medicaid all have the potential to improve access to mental health and substance abuse treatment and to alter spending patterns further. Our spending estimates provide an important context for evaluating the effect of those policies.


Asunto(s)
Costos de la Atención en Salud , Reforma de la Atención de Salud , Gastos en Salud/estadística & datos numéricos , Política de Salud , Servicios de Salud Mental/economía , Centros de Tratamiento de Abuso de Sustancias/legislación & jurisprudencia , Trastornos Relacionados con Sustancias/terapia , Adulto , Producto Interno Bruto , Gastos en Salud/tendencias , Humanos , Medicaid , Servicios de Salud Mental/tendencias , Centros de Tratamiento de Abuso de Sustancias/economía , Trastornos Relacionados con Sustancias/prevención & control , Estados Unidos
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