Purpose The use of atypical antipsychotic (AAP) medications in the pediatric population is increasing. Only one AAP recently received FDA approval (Risperdal, October 2006) for use in children with autism and disruptive behavior; otherwise, use of AAP medications in children is “off-label.” Data supporting safety and effectiveness in pediatrics are quite limited. Our purpose was to assess the prevalence and growth pattern of AAP use in the pediatric Medicaid population in Arkansas.
Methods Pharmacy claims data for Arkansas Medicaid recipients filling an AAP prescription between January 2000 and June 2006 were analyzed. The population was controlled for continuous Medicaid benefit eligibility. The results are descriptive analyses of aggregate AAP prescribing patterns for roughly half of all Arkansas children.
Results Between January 2000 and June 2006, there was a 5.4-fold increase in raw number of prescriptions written for AAP to patients under the age of 18. By January 2005, prescriptions to pediatric patients for AAP had surpassed the number of prescriptions written for adults, and in June 2006, pediatric patients represented 53% of the total AAP prescribed that month. Prevalence calculations were made controlling for continuous Medicaid benefit eligibility. The data revealed doubling of the rate of use of AAPs in children since 2000.
Conclusions The use of AAP medicines in children enrolled in Medicaid/ARKids has increased at an alarming rate. This has occurred despite limited research to support the use of AAP in pediatrics and no FDA approval for the use of any AAP in pediatrics for the time frame of this study. Although the FDA recently approved the use of one AAP with autism, Medicaid-eligible children in Arkansas are prescribed AAP medicines more often than the recently reported prevalence of autism (1 in 166 in the pediatric population, or 0.6%). For children between the ages of 5 and 18, roughly 2 of every 100 children eligible for Medicaid in Arkansas are receiving prescriptions for an AAP medication.
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