One of the most controversial areas for health care reform concerns the treatment of alcohol and other drug problems, which account for some of the most rapidly rising costs in the health care sector. There is arguably no other set of conditions that show such variation in accessibility to treatment on the basis of insurance status, present the same degree of difficulty in providing comprehensive care, or challenge as many public and professional assumptions about behavioral, social and economic determinants. The purpose of this article is to discuss some of the financing and coverage barriers to comprehensive treatment for alcohol and other drug abuse; to discuss some innovative mechanisms for providing and financing comprehensive services; and to suggest some directions for public policy to support the development of new practice models that emphasize cost-effectiveness and efficiency of care.

Many state Medicaid programs have implemented policies designed to reduce spending on prescription drugs by restricting access to branded products. For patients with major depressive disorder, formulary restrictions could severely limit access to antidepressant therapies and disrupt care. We linked data on patient outcomes and spending from 24 state Medicaid programs to information on formulary restrictions from 2001 to 2008. Outcomes included frequency of MDD-related hospitalizations and ER visits per patient and total healthcare spending. We estimated the effect of the policies on patient outcomes and spending using a difference-and-difference approach. We found that restricting access to antidepressants increased the probability of an MDD-related hospitalization by 1.7 percentage points (16.6%). Furthermore, we found no evidence that these restrictions resulted in any net savings for Medicaid.

generation antipsychotics (SGAs) were prescribed regardless of mono-therapy or combination therapy. Risperidone [n= 17 (56.7%)] was most frequently prescribed, followed by aripiprazole [n= 7 (23.3%)] and olanzapine [n= 5 (16.7%)]. Haloperidol was the predominant first generation antipsychotic (FGA) prescribed [n= 3(10%)]. Of the patients on combination therapy [n= 12], most [n= 10 (83.3%)] were on combination of two or more SGAs. A majority [n= 18(60%)] of the patients had an unchanged outcome at the time of discharge. ConClusions: The results of the study indicate that the therapy prescribed does not meet the clinical goals for the patients. A larger study is required to assess the prescription patterns and the predictors of outcomes among schizophrenics in the Indian population. PMH80 10-Year Medication utilization trends for stiMulant, antidePressant, and antiPsYcHotic Medications in texas Medicaid cHildren aged 3 Years old or Younger