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Does Medicaid Pay Too Much for Prescription Drugs? A Case Study of Atypical Anti-Psychotics

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  • Mark G. Duggan

Abstract

During the last several years, government spending on drugs used to treat schizophrenia and other psychotic illnesses has increased at more than 30% per year, with the $3 billion in 2001 Medicaid expenditures exceeding spending in any other therapeutic category. This growth has been primarily driven by a shift to atypical anti-psychotic drugs, which are several times more expensive than the conventional anti-psychotics that preceded them and are purchased almost exclusively by state governments through the Medicaid program. In this paper, I estimate the productivity of these new drugs using a 5% sample of California Medicaid recipients eligible for the program in at least one month between January of 1993 and December of 2001 and diagnosed with schizophrenia during that period. My results indicate that the shift to atypical anti-psychotics has significantly increased government spending, has not reduced the utilization of hospitals or long-term care facilities, and has not improved observable measures of health among Medicaid recipients. The findings suggest that the price of a prescription drug purchased differentially by consumers with Medicaid or other public health insurance may be an inaccurate measure of it value to patients.

Suggested Citation

  • Mark G. Duggan, 2003. "Does Medicaid Pay Too Much for Prescription Drugs? A Case Study of Atypical Anti-Psychotics," NBER Working Papers 9626, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:9626
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    References listed on IDEAS

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    1. Duggan, Mark, 2004. "Does contracting out increase the efficiency of government programs? Evidence from Medicaid HMOs," Journal of Public Economics, Elsevier, vol. 88(12), pages 2549-2572, December.
    2. Berndt, Ernst R. & Finkelstein, Stan N. & Greenberg, Paul E. & Howland, Robert H. & Keith, Alison & Rush, A. John & Russell, James & Keller, Martin B., 1998. "Workplace performance effects from chronic depression and its treatment," Journal of Health Economics, Elsevier, vol. 17(5), pages 511-535, October.
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    Cited by:

    1. Duggan, Mark, 2005. "Do new prescription drugs pay for themselves?: The case of second-generation antipsychotics," Journal of Health Economics, Elsevier, vol. 24(1), pages 1-31, January.
    2. Frank, Richard G. & Berndt, Ernst R. & Busch, Alisa B. & Lehman, Anthony F., 2004. "Quality-constant "prices" for the ongoing treatment of schizophrenia: an exploratory study," The Quarterly Review of Economics and Finance, Elsevier, vol. 44(3), pages 390-409, July.
    3. Nasreen Khan & Robert Kaestner & Swu Jane Lin, 2007. "Prescription Drug Insurance and Its Effect on Utilization and Health of the Elderly," NBER Working Papers 12848, National Bureau of Economic Research, Inc.
    4. Richard G. Frank & Ernst R. Berndt & Alisa B. Busch, 2003. "Quality-Constant Price Indexes for the Ongoing Treatment of Schizophrenia: An Exploratory Study," NBER Working Papers 10022, National Bureau of Economic Research, Inc.

    More about this item

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H57 - Public Economics - - National Government Expenditures and Related Policies - - - Procurement

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