Reducing off-label drug use could reduce medical expenses


Medical costs are soaring and one way to reduce costs would be to stop using antipsychotic drugs off-label. This is according to new research from Penn State College of Medicine. As many as 57% of patients prescribed these medications do not have schizophrenia or bipolar disorder, the conditions the drugs were meant to treat.

“Given healthcare reform and widespread crisis in state revenues, state Medicaid programs will be under pressure to serve larger patient populations, increasing their fiscal stress,” explained Douglass L. Leslie, PhD, professor of public health sciences. “Medicaid prescription drug programs covered 75% of all antipsychotic prescription medications in the United States in 2002. Reducing off-label antipsychotic use may generate savings with little impact on patient outcomes.”

People who are taking the drugs may not have been diagnosed with schizophrenia or bipolar disorder, but they do have minor depression, major depression, conduct disorder and anxiety disorder. Some did not have mental conditions at all.

“A high rate of off-label antipsychotic use would not necessarily be of concern if there were scientific evidence supporting the effectiveness of these medications for conditions other than schizophrenia and bipolar disorder,” Leslie said.

Off-label use is not unusual. The American Academy of Neurology endorses it for some treatments. Other off label uses are for irritability caused by autism and depression. Since the study began in 2003, these are now FDA approved uses for the medications.

“Antipsychotics were the highest selling medication class at $14.6 billion in 2009,” Leslie noted. “Medicaid bears a significant proportion of these costs. Hence, off-label use may be responsible for a considerable portion of state Medicaid budgets, with little or no documented clinical benefit and a substantial risk of adverse effects.”

Source: MedicalNewsToday, Penn State College of Medicine


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