Objectives: This study analyzed the distribution of first and second-generation antipsychotic medications across several demographic variables of patients in a Medicaid population. Methods: Patients continuously eligible between 01/01/96 and 06/30/98, and dispensed haloperidol, perphenazine, and thioridazine (first-generation) or clozapine, olanzapine, risperidone (second-generation) between 01/01/97 and 06/30/97 were extracted from a Medicaid demographic database for analysis. Results: Patients that received first-generation agents (n=12,012) were significantly older (p£0.001) than those on second-generation agents (n=10,157), 52.9 versus 48.5 years, respectively. Females were significantly more likely (p£0.001) to have received a first than a second-generation agent (55.9% vs 44.1%), whereas males were more evenly distributed (51.7% vs. 48.3%). Significantly more blacks (61.8%), hispanics (58.4%), and patients of unknown race (58.2%) received first-generation agents than did whites (49.8%, p£0.001). Patients in rural areas were also significantly more likely (p£0.001) to have received first-generation agents (62.0%) than were urban patients (53.5%). Conclusions: Although statistically significant, there may be no practical difference between first and second-generation antipsychotic medications with regard to patient age and sex. However, these results suggest prominent race and regional disparities disadvantageous to minority and rural patients in the distribution of second-generation antipsychotic agents. The racial disparity is of particular concern given evidence suggesting blacks may be at greater risk for tardive dyskinesia, a potential side effect of first generation antipsychotic agents.
Learning Objectives: Develop an awareness of racial and regional disparities in the distribution of first-generation antipsychotic medications
Keywords: Prescription Drug Use Patterns, Medicaid
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Eli Lilly and Company manufactures the second-generation antipsychotic medication olanzapine. A former subsidiary of Eli Lilly and Company, PCS Health Systems' incentive savings program matches employee-contributed funds with Eli Lilly and Company stocks