Study to examine long-term physical health outcomes in Florida’s Medicaid children receiving state’s prior authorization for antipsychotic treatment

Yu-Jung “Jenny” Wei, Ph.D., an assistant professor of pharmaceutical outcomes and policy, has partnered with the University of South Florida Medicaid Drug Therapy Management Program Center to lunch a new study that looks at the long-term physical health outcomes of Florida’s Medicaid children under six years old who received the state’s prior authorization, or PA, for antipsychotic treatment. A collaboration of researchers from the University of Florida College of Pharmacy are involved with the project, including Almut Winterstein, Ph.D., a professor and chair of the department of pharmaceutical outcomes and policy, Xinyu Lin, Ph.D., a postdoc fellow, as well as pediatric psychiatrists from the UF department of psychiatry, Regina Bussing, M.D., professor and interim chair, and Nikhil Rao, M.D., a child and adolescent fellow.

Implemented in April 2008, the Florida’s Medicaid policy for the antipsychotic PA program has acted as a gatekeeper by requiring all children recipients to meet specific clinical criteria before the medications are prescribed. This PA system gives both the prescribers, and children and their patients/guardians an opportunity to justify the clinical needs for antipsychotics.

While antipsychotics help control psychiatric and mental symptoms, the treatment does come with some side effects. Most of them are related to physical issues, including extrapyramidal side effects, cardiovascular risk and metabolic diseases, such as diabetes. To ensure that all children enrollees receive antipsychotics without the risks outweighing the benefits, a close monitoring of the physical health outcomes is crucial.

This new study is going to focus on the very young children — those under six years old — who are unfortunately diagnosed with psychiatric or mental disorders and therefore, require antipsychotics through the PA program to manage the symptoms. Using PA registry data that are linked with Florida’s Medicaid billing records, this project provides an invaluable opportunity to study the incidence and distribution of various types of long-term physical health outcomes over a maximum of seven years from the start of the PA program in 2008. In addition, this study will investigate whether the risks for long-term physical health disorders vary by age, race/ethnicity, and duration of antipsychotic use. The study results are expected to lay a groundwork for future research that examines the effectiveness of the antipsychotic PA program for improving children’s health outcomes, both mental and physical.