Julie M. Donohue

Effects of Pharmaceutical Promotion on Adherence to the Treatment Guidelines for Depression

Objectives:We sought to examine the impact of direct-to-consumer advertising (DTCA) and pharmaceutical promotion to physicians on the likelihood that (1) an individual diagnosed with depression received antidepressant medication and that (2) antidepressant medication was used for the appropriate duration. Research Design and Subjects:A quasiexperimental design was used to examine treatment patterns of 30,621 depressed individuals whose insurance claims were included in the MarketScan database from 1997 through 2000. The main explanatory variables were spending on DTCA, detailing to physicians, and free samples for 6 antidepressant medications. Results:Individuals diagnosed with depression during periods when class-level antidepressant DTCA spending was highest (cumulative spending more than

The Effect of Medicare Part D on Drug and Medical Spending

18.5 million) had 32% higher relative odds of initiating medication therapy compared with those diagnosed during periods when DTCA spending was lowest (P < 0.0001). Free samples of medications dispensed to physicians had no effect on odds of initiating antidepressant use. Class-level DTCA spending on antidepressants had a small positive effect on the duration of antidepressant use, whereas DTCA spending for the specific medication taken by an individual had no effect on treatment duration. Detailing spending at the class or product level had no significant effect on duration of treatment with an antidepressant medication. Conclusions:Our results suggest that DTCA of antidepressants was associated with an increase in the number of people diagnosed with depression who initiated medication therapy. DTCA was associated with a small increase in the number of individuals treated with antidepressants who received the appropriate duration of therapy. Promotion to physicians was not associated with either the initiation of treatment with an antidepressant or with the duration of therapy.

The Impact of National Health Care Reform on Adults With Severe Mental Disorders

BACKGROUND It is not known what effect the increased use of prescription drugs by enrollees in Medicare Part D has had on spending for other medical care. METHODS We compared spending for prescription drugs and other medical care 2 years before the implementation of Part D in January 2006 with such expenditures 2 years after the programs implementation in four groups of elderly beneficiaries: Medicare Advantage enrollees with stable, uncapped, employer-based drug coverage throughout the study period (no-cap group), those who had no previous drug coverage, and those who had previous limited benefits (with either a

Effects of Direct-to-Consumer Advertising on Medication Choice: The Case of Antidepressants

150 or a

The Effects Of The Coverage Gap On Drug Spending: A Closer Look At Medicare Part D

350 quarterly cap) before they were covered by Part D in 2006. RESULTS Between December 2005 and December 2007, as compared with the increase in the no-cap group, the increase in total monthly drug spending was

Promotion of Prescription Drugs to Consumers and Providers, 2001–2010

41 higher (95% confidence interval [CI],

Trends in use of antipsychotics in elderly patients with dementia: impact of national safety warnings

33 to

Hepatitis C Disease Burden in the United States in the era of oral direct-acting antivirals

50) (74%) among enrollees with no previous drug coverage,

Prevalence and correlates of self-reported medication non-adherence among older adults with coronary heart disease, diabetes mellitus, and/or hypertension.

27 higher (95% CI,

Collaborative Depression Care Management and Disparities in Depression Treatment and Outcomes

20 to