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The Antipsychotic Atlas Project - Overview

The Antipsychotic Atlas Project - Overview Kennedy , J (PI); S Murphy ; S McPherson & M Layton (co-Is) Start date: 9/13 End date: 8/15

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The Antipsychotic Atlas Project - Overview

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  1. The Antipsychotic Atlas Project - Overview Kennedy, J (PI); S Murphy; S McPherson & M Layton (co-Is) Start date: 9/13 End date: 8/15 This research project is intended to benefit Washington residents with dementia, schizophrenia, bipolar disorder or diabetes and is funded by a $340,288 grant awarded from the Washington State Attorney General’s Office. The grant originated as part of a “cy pres,” or “next best use” of settlement monies, stemming from a 2012 settlement agreement between the Washington State Attorney General’s Office and Janssen Pharmaceuticals, Inc., concerning the marketing of Risperdal, Risperdal Consta, Risperdal M-Tab and Invega.

  2. The Antipsychotic Atlas Project – Background • The top five atypical antipsychotics account for over $8 billion in annual U.S. sales, paid mostly by the federal Medicare and Medicaid programs. • These antipsychotic medications are approved by the Federal Drug Administration (FDA) for treatment of schizophrenia and bipolar disorder, but are also prescribed to millions of Americans with other psychiatric conditions. • Information on the current scope of off-label prescribing and other clinically important antipsychotic use patterns is quite limited.

  3. The Antipsychotic Atlas Project – Study Objectives • The objective of this two year study is to provide a detailed portrait of antipsychotic utilization in Washington at the regional support network (RSN) and county level. • We will use newly released Medicare D claims data to document patient level disparities in use, including off label use and nonadherence. • We will then assess relative rates of metabolic syndrome, stroke, and thromboembolism among WA antipsychotic users.

  4. Descriptive analysis of antipsychotic users Denominator file All 2010 WA Part D Beneficiaries (includes Medicare Advantage) N = 477,310 Numerator file 1+ antipsychotic prescriptions N = 29,973 6.3% of WA Part D recipients filled an antipsychotic prescription in 2010

  5. Antipsychotic prescription use by WA county

  6. Anti-Psychotic Use by County

  7. Antipsychotics Used in 2010 and 2011

  8. WA Antipsychotic User Attributes

  9. The Antipsychotic Atlas Project – What’s Next? • Patterns of prescription drug events or PDEs (N=2.4 million) • Antipsychotic medication discontinuation • Without replacement (nonadherence) • With replacement (switching) • Excessive or subtherapeutic dosing • Simultaneous use of psychiatric medications (polypharmacy)

  10. The Antipsychotic Atlas Project – What’s Next? • Analysis of inpatient and outpatient services • (fee for service beneficiaries; N=1.3 million claims) • Off-label prescribing rates (by drug, county and recipient attributes) • Adverse clinical outcomes (metabolic syndrome, stroke, thromboembolism)

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