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Keywords:

  • adolescents;
  • antipsychotic medications;
  • children;
  • health-care costs;
  • health-care utilization

ABSTRACT

Objective:  To examine the differences over time in health-care costs associated with incident adverse events in children and adolescents treated with antipsychotic agents compared to an untreated control sample.

Method:  A retrospective cohort design evaluating South Carolina's Medicaid medical and pharmacy claims between January 1996 and December 2005 was employed for 4140 children and adolescents prescribed antipsychotic medications, and a random sample of 4500 children not treated with psychotropic medications. The main outcome measures were total health-care costs and emergency, inpatient, and outpatient services use.

Results:  Patients with the focal adverse medical conditions incurred significantly higher total care costs (34% higher, on average, over 8–9 years) compared with those without these conditions (F = 710.08; P < 0.0001) or to children not treated with psychotropic medications (F = 2855.54; P < 0.0001). Patients with incident adverse events associated with antipsychotic treatment had significantly higher rates/time under Medicaid coverage of outpatient, emergency, and inpatient services utilization than the control sample patients, controlling for preexisting conditions, receipt of multiple psychotropic medications, and individual risk factor differences for males, adolescents, and non-African Americans.

Conclusions:  The development of adverse medical conditions related to antipsychotic medication use in children and adolescents is significantly associated with higher total costs of health care and to utilization of outpatient, emergency, and inpatient services over time.