This article examines the effects of a prior authorization policy put into effect by Maine Medicaid to control the cost of psychotropic medications.
Little is known about whether such prior authorizations have unintended consequences on treatment for mental illness. The Maine prior authorization policy requires that bipolar patients receiving second-generation antipsychotics must be treated first with preferred medications before receiving reimbursement for non-preferred medications. The authors compared data from 5,336 Maine residents with bipolar disorder with a control group of 1,376 patients from New Hampshire. Using an interrupted time series with a comparison group allowed researchers to study the implementation of the Maine prior authorization policy.
These findings suggest that the prior authorization policy achieved its goal of reducing the number of new patients prescribed non-preferred treatments, while not affecting the treatment patterns of patients already established on non-preferred medications.