Spending for prescription medications for the treatment of mental health and substance abuse (MH/SA) disorders rose 20 percent per year between 1996 and 2001, while use of outpatient services for these conditions remained constant during this period. As a result, nearly 5.5 million more Americans received treatment for mental disorders in 2001 than in 1996, according to a study by Samuel H. Zuvekas, of the Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality. Dr. Zuvekas analyzed data from the Medical Expenditure Panel Survey, a large ongoing household survey of noninstitutionalized U.S. civilians.
The percentage of Americans with outpatient visits for MH/SA treatment remained flat during the study period, while use of MH/SA drugs increased. A drop in the average number of outpatient visits was offset by an increase in the average spending per visit. However, prescription drug spending more than doubled. Of the total increase, 37 percent was accounted for by new users and 63 percent by higher spending per user. Among MH/SA treatment users, 36 percent reported outpatient visits without prescription drug purchases in 1996, but only 25 percent did so in 2001. In contrast, 34 percent of MH/SA treatment users reported only drug purchases in 2001, up from 26 percent in 1996.
About 80 percent of the growth in MH/SA drug spending during 1996-2001 was explained by two medication classes: selective serotonin reuptake inhibitors and other newer antidepressants (52 percent) and atypical antipsychotics (28 percent). Anticonvulsant drugs used to treat bipolar disorder (9 percent), benzodiazepines and anti-anxiety medications (7 percent), and stimulants such as methylphenidate (ritalin) and amphetamines (4 percent) accounted for the rest.
More details are in "Prescription drugs and the changing patterns of treatment for mental disorders, 1996-2001," by Dr. Zuvekas, in the January 2005 Health Affairs 24(1), pp. 195-205. Reprints (AHRQ Publication No. 05-R031) are available from the AHRQ Publications Clearinghouse.
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