Abstract
AbstractIntroductionCitalopram and escitalopram are among the most used medications and are key treatments for many psychiatric disorders. Previous findings suggest citalopram and escitalopram prescription rates are changing because of the patent for citalopram ending as opposed to evidence of a clear therapeutic advantage, which is called evergreening. This retrospective study focuses on characterizing the chronologic and geographic variation in the use of citalopram and escitalopram among US Medicaid and Medicare patients. We hypothesized that prescription rates of citalopram will decrease with a concurrent increase in escitalopram, consistent with evergreening.MethodsCitalopram and escitalopram prescription rates and costs per state were obtained from the Medicaid State Drug Utilization Database and Medicare Provider Utilization and Payment Data. Annual prescription rates outside a 95% confidence interval were considered significantly different from the average.ResultsOverall, a decreasing trend for citalopram and an increasing trend for escitalopram prescription rates were noted in both Medicare and Medicaid patients. Cost differences between generic and brand were noted for both drugs, with generic forms being cheaper compared to the brand-name version.DiscussionDespite limited evidence suggesting that citalopram and escitalopram have any meaningful differences in therapeutic or adverse effects, there exists a noticeable decline in the use of citalopram that cooccurred with an increase in escitalopram prescribing, consistent with our hypothesis. Moreover, among these general pharmacoepidemiologic trends exists significant geographic variability. There was disproportionate spending (relative to their use) on the brand versions of these medicines compared to their generic forms.
Publisher
Cold Spring Harbor Laboratory
Reference41 articles.
1. Aguilar, A. G. , Beauregard, B. A. , Conroy, C. P. , Khatiwoda, Y. T. , Horsford, S. M. E. , Nichols, S. D. , & Piper, B. J. (2023). Pronounced regional variation in esketamine and ketamine prescribing to us medicaid patients. Journal of Psychoactive Drugs, 1–7. https://doi.org/10.1080/02791072.2023.2178558
2. Impact of evergreening on patients and health insurance: A meta-analysis and reimbursement cost analysis of citalopram/escitalopram antidepressants;BMC Medicine,2012
3. Drug expenditure, price, and utilization in the U.S. Medicaid: A trend analysis for SSRI and SNRI antidepressants from 1991 to 2018;The Journal of Mental Health Policy and Economics,2021
4. American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th, Text Revision ed.).
5. Heatmapper: web-enabled heat mapping for all
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