Estimating the impact of prior authorization on medication use patterns and adverse health outcomes of Medicaid beneficiaries with bipolar disorder

The Foundation's Changes in Health Care Financing and Organization program was designed to support research, demonstration, and evaluation projects examining major changes in health care financing.Under this project, the researchers will evaluate the effects of prior authorization of new medications among Medicaid beneficiaries with bipolar disorder in the State of Maine. As part of their study, they will: (1) describe baseline demographic and clinical characteristic and patterns of treatment; (2) examine the impact of prior authorization on utilization and expenditures of preferred versus non-preferred atypical antipsychotic (AA) agents and anticonvulsant (AC) agents among patients continuously enrolled for the entire study period in Maine and New Hampshire (comparison state); and (3) examine the impact of prior authorization on rates of hospital admission and rates of cessation of all medical treatment, two potential adverse outcomes. The objective of the project is to examine the effect of prior authorization, an increasingly popular drug utilization management policy for patients with chronic mental illness, on medication use and associated outcomes.

Grant Details

Amount Awarded $231,641.00

Awarded on: 9/12/2007

Time frame: 10/1/2007 - 9/30/2009

Grant Number: 63213


Harvard Pilgrim Health Care Inc.

93 Worcester Street
Wellesley, 02148-3609


Stephen B. Soumerai
Project Director