The use of conventional antipsychotic medications for patients with schizophrenia in a Medicaid population: therapeutic and cost outcomes over 2 years.
Researchers found that California Medicaid (Medi-Cal) patients with schizophrenia who initiated therapy with conventional antipsychotics frequently exhibited suboptimal drug use patterns, such as delaying treatment, switching between alternative antipsychotic medications, and using medication inconsistently, all of which increased overall health care costs. The results suggest that interventions must be developed to reduce the rate at which patients abstain from or delay antipsychotic drug therapy, or switch between alternative antipsychotic medications over time; any successful intervention in antipsychotic drug therapy may also achieve significant offsetting savings.

Published by Value in Health in May/June 2000.  Authors: McCombs JS, Luo M, Johnstone BM, Shi L.

Hospital Readmission Rates Among Patients with Schizophrenia Treated With Long-Acting Injectables or Oral Antipsychotics
Compared with use of oral antipsychotics, use of long-acting injectables (LAIs) was associated with fewer hospital readmissions for Medicaid patients with schizophrenia within 60 days of the patient’s initial hospitalization.

Published by Psychiatric Services on July 15, 2016.  Authors: Joanna P. MacEwan, Ph.D., Siddhesh A. Kamat, M.S., M.B.A., Ruth A. Duffy, Ph.D., Seth Seabury, Ph.D., Jacquelyn W. Chou, M.P.P., M.P.L., Susan N. Legacy, M.D., Ann Hartry, Ph.D., Anna Eramo, M.D., and Craig Karson, M.D.

Medicaid Access Restrictions on Psychiatric Drugs:  Penny-wise or Pound-Foolish?
Paper shows that Medicaid formulary restrictions, such as prior authorization and step therapy, save little, if any money on drug spending.  Instead, formulary restrictions increase overall Medicaid spending for people with serious mental illness.

Published as an issue brief by the USC Schaeffer Center for Health Policy and Economics in February 2015 (not peer reviewed).

Formulary Restrictions on Atypical Antipsychotics: Impact on Costs for Patients With Schizophrenia and Bipolar Disorder in Medicaid
By studying formulary restrictions across 24 state Medicaid programs, authors show that applying formulary restrictions to atypical antipsychotics is associated with higher total medical expenditures for patients with schizophrenia and bipolar disorder. Combined with the other social costs such as an increase in incarceration rates, these formulary restrictions could increase state costs by $1 billion annually, enough to cancel out any savings in pharmacy costs.

Published in the American Journal of Managed Care.  Authors: Seth A. Seabury, PhD; Dana P. Goldman, PhD; Iftekhar Kalsekar, PhD; John J. Sheehan, PhD; Kimberly Laubmeier, PhD; and Darius N. Lakdawalla, PhD.

Medicaid Cost Control Measures Aimed At Second-Generation Antipsychotics Led To Less Use Of All Antipsychotics
In examining thirty state Medicaid programs between 1999 and 2008, authors found that 11 states that instituted prior authorization requirements for atypical anti-psychotics had a drop in the use of atypical antipsychotics, but the decrease was not dramatic.  However, the policy did result in spillover costs because it reduced the use of all types of antipsychotics, meaning more patients went without any medication.

Published in Health Affairs in 2011.  Authors: William B. Vogt, Geoffrey Joyce, Jing Xia, Riad Dirani, George Wan and Dana P. Goldman.