Evidence map›Paper›PMID 26799124›Full record

ArticleThe American journal of managed care2016

The introduction of generic risperidone in Medicare Part D.

Vicki Fung, Mary Price, Alisa B Busch, Mary Beth Landrum, Bruce Fireman, Andrew A Nierenberg, Joseph P Newhouse, John Hsu

Abstract read
In one paragraph

Article in The American journal of managed care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Vicki Fung50 Staniford St, 9th Fl, Boston, MA 02114. E-mail: vfung@mgh.harvard.edu.
Mary Price
Alisa B Busch
Mary Beth Landrum
Bruce Fireman
Andrew A Nierenberg
Joseph P Newhouse
John Hsu

Funding

Medicare Drug Benefits and High Cost Medications: Antipsychotics Under Part DR01MH090284 · NIMH · MASSACHUSETTS GENERAL HOSPITAL · PI FUNG, VICKI · 2011 to 2013
$1.7M
NIMH NIH HHS R01 MH090284NIMH NIH HHS R01MH090284
6 · The paper itself

Abstract

objectivesThe introduction of generic second-generation antipsychotics (SGAs), starting with risperidone in July 2008, could reduce antipsychotic spending and cost-related use barriers. This study examines associations between generic risperidone use and spending and adherence after introduction among Medicare Advantage (MA) beneficiaries. STUDY

designHistoric cohort study.

methodsThe study included MA beneficiaries receiving SGA treatment prior to July 2008. We examined antipsychotic spending using linear models, adherence (proportion of days covered ≥ 80%) using logistic models, and nonpersistence (time to first gap in antipsychotic use > 30 days) in 2009 using Cox proportional hazard models, comparing beneficiaries with versus without generic use, adjusting for individual and plan characteristics.

resultsBetween July 2008 and December 2009, 22.8% of beneficiaries had ≥ 1 fill of generic risperidone: 73% of those previously using branded risperidone and 6.7% of those previously using other SGAs. Beneficiaries in private fee-for-service (FFS) versus health maintenance organization (HMO) plans had lower rates of generic use (hazard ratio [HR], 0.73 [95% CI, 0.56-0.96]); however, cost-sharing levels were not associated with generic use. Compared with beneficiaries who continued using other SGAs, those who switched from other SGAs to generic risperidone in 2008 had lower out-of-pocket spending (-$214; 95% CI, -$314 to -$115), higher adherence (odds ratio, 2.34; 95% CI, 1.62-3.40) and lower rates of nonpersistence (HR, 0.56; 95% CI, 0.46-0.69) in 2009.

conclusionsGeneric use was concentrated among patients previously using branded risperidone. HMO plans appeared to be more effective at encouraging generic use than unmanaged private FFS plans; however, patient financial incentives had limited influence on switching. Additional opportunity remains to encourage greater generic SGA use, reduce spending, and potentially improve treatment adherence and outcomes.

Indexed as

Medicare Part DAgedAntipsychotic AgentsCohort StudiesDrug MonitoringDrugs, GenericFemaleHumansMaleMedicare Part CRisperidoneUnited StatesAntipsychotic AgentsDrugs, GenericRisperidone

Identifiers

PMID26799124
PMCPMC4915110

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.