The past two decades were a period of rapid development of new drug treatments for mental illness. For many patients, the new medications represent advances over existing drugs with respect to efficacy and/or side effects, and are generally easier for physicians to administer. Some believe these new drugs have brought about “revolutionary” changes in the treatment of mental illness. At the same time, the growth in psychotropic drug costs has been explosive. Rapid cost increases combined with high accounting profits have brought increased scrutiny to drug manufacturers over whether the drugs they produce are worth the costs. Industry critics argue that while some medications have been genuine “breakthrough” drugs (e.g., the first SSRIs, such as Prozac), “me-too” drugs and product reformulations have resulted in only modest treatment changes because of their similarity to existing drugs.
This study will compare the social costs and benefits of the newer psychotropic drugs to assess their social value and then identify ways that the value of psychotropic drug spending can be increased. Because no single empirical analysis will address this issue, the research will entail assembling data from the clinical, health services, economics, marketing, and regulatory literatures, as well as conducting supplemental data analyses to fill gaps in knowledge.
The study will use evidence from clinical trials to assess the potential benefits of the newer drugs relative to older drugs for subpopulations of users; combine this evidence with data on drug diffusion patterns to assess the relative value of these medications as they are used in practice; and examine public and private policy levers that could yield greater social value for psychotropic spending, including pharmacy management tools, Medicaid pricing rules, and regulatory policies governing drug competition and promotion. This project will provide information that is directly relevant to the key policy levers affecting psychotropic pricing and utilization and will be useful to a broad audience, including policymakers, regulators, administrators, clinicians, patients, advocacy groups, and researchers.
