ArticleClinical therapeutics2015
Effects of eliminating drug caps on racial differences in antidepressant use among dual enrollees with diabetes and depression.
Article in Clinical therapeutics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 13 citations in OpenAlex.
- Association of state medicaid prescription cap policies with trajectories of buprenorphine use for opioid use disorder.Journal of substance use and addiction treatment · 2025Article
- Patient preferences for medication adherence financial incentive structures: A discrete choice experiment.Research in social & administrative pharmacy : RSAP · 2021Article
- Association Between Medicaid Prescription Drug Limits and Access to Medications and Health Care Use Among Young Adults With Disabilities.JAMA health forum · 2021Article
- Perceived appropriateness of medication adherence incentives.Journal of managed care & specialty pharmacy · 2021Article
- Study protocol: Using peer support to aid in prevention and treatment in prediabetes (UPSTART).Contemporary clinical trials · 2020Article
- Accountable Care Organizations and Preventable Hospitalizations Among Patients With Depression.American journal of preventive medicine · 2020Article
- Advancing mental health equality: a mapping review of interventions, economic evaluations and barriers and facilitators.Systematic reviews · 2020Review
- Impacts of the Dependent Care Expansion on the Allocation of Mental Health Care.Administration and policy in mental health · 2019Article
- Effects of Transitioning to Medicare Part D on Access to Drugs for Medical Conditions among Dual Enrollees with Cancer.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2017Article
Corrections and comments
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Authors and funding
12 authors at 7 institutions in 1 country.
Funding
Abstract
purposeBlack patients with diabetes are at greater risk of underuse of antidepressants even when they have equal access to health insurance. This study aimed to evaluate the impact of removing a significant financial barrier to prescription medications (drug caps) on existing black-white disparities in antidepressant treatment rates among patients with diabetes and comorbid depression.
methodsWe used an interrupted time series with comparison series design and a 5% representative sample of all fee-for-service Medicare and Medicaid dual enrollees to evaluate the removal of drug caps on monthly antidepressant treatment rates. We evaluated the impact of drug cap removal on racial gaps in treatment by modeling the month-to-month white-black difference in use within age strata (younger than 65 years of age or 65 years of age or older). We compared adult dual enrollees with diabetes and comorbid depression living in states with strict drug caps (n = 221) and those without drug caps (n = 1133) before the policy change. Our primary outcome measures were the proportion of patients with any antidepressant use per month and the mean standardized monthly doses (SMDs) of antidepressants per month.
findingsThe removal of drug caps in strict drug cap states was associated with a sudden increase in the proportion of patients treated for depression (4 percentage points; 95% CI, 0.03-0.05, P < 0.0001) and in the intensity of antidepressant use (SMD: 0.05; 95% CI, 0.03-0.07, P < 0.001). Although antidepressant treatment rates increased for both white and black patients, the white-black treatment gap increased immediately after Part D (0.04 percentage points; 95% CI, 0.01-0.08) and grew over time (0.04 percentage points per month; 95% CI, 0.002-0.01; P < 0.001). IMPLICATIONS: Policies that remove financial barriers to medications may increase depression treatment rates among patients with diabetes overall while exacerbating treatment disparities. Tailored outreach may be needed to address nonfinancial barriers to mental health services use among black patients with diabetes.
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