Healthy Skepticism Library item: 7740

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Publication type: Journal Article

Del PAGGIO.
Evaluation of atypical antipsychotic medication assistance programs in a county mental health system
ASHP Midyear Clinical Meeting 2002;

Abstract:

The success of atypical antipsychotic patient assistance programs (PAPs) in a network of community mental health providers seeing large numbers of indigent patients. To determine the effectiveness of atypical antipsychotic patient assistance programs (PAPs) by contrasting their characteristics, including the application process, eligibility criteria, acceptance percentage, approval period and ultimate cost savings. A total of 320 indigent patients receiving atypical antipsychotics (olanzapine, quetiapine, risperidone) from 12 different sites were prospectively enrolled during the period 7/1/2000 6/30/2001. Data collected included the PAP application initiation, processing and eligibility determination for each patient, as well as resulting medication supply, cost and re-application process. Finally, the percentage of patients achieving third-party eligibility was tracked. Each PAP was unique in regards to overall process, eligibility requirements, medication quantity supplied, and re-application. Olanzapine (n=161): 65% application approval, 614 prescriptions, mean 5.8 prescriptions per application and total cost savings of $157,798. Quetiapine (n=41): 61% approval, 61 prescriptions, mean 2.4 prescriptions 21 per application, cost savings $13,237. Risperidone (n=118): 54% approval, 176 prescriptions, 2.8 prescriptions per application, cost savings $30,096. A total of sixty-five percent of the patients achieved third-party eligibility at 1 year. Favorable program characteristics for safety-net providers included provider eligibility determination, bulk medication shipment and information exchanged through email. Ultimately, the olanzapine PAP had the highest approval rate, number of prescription per application and associated cost savings. Streamlining PAPs for utilization by safety net providers providing care to large numbers of indigent patients is necessary.