Maryland Part D Plans Enrolling Duals Require Prior Authorization On Nearly 20% Of Some Antipsychotic Prescriptions

Medicare Part D prescription plans required prior authorization for nearly one-fifth of prescriptions for certain atypical antipsychotics and mood stabilizers prescribed to dual eligible Maryland Medicare-Medicaid beneficiaries with serious mental illness (SMI) in 2009. Between 15% and 19% of prescriptions for the second generation antipsychotics aripiprazole, olanzapine, and ziprasidone were subject to prior authorization. About 20% of prescriptions for the mood stabilizer oxcarbazepine were subject to prior authorization. In 2009, these four medications had the highest prior authorization rates across six second generation antipsychotics and five mood stabilizers.

These findings were reported in “Part D Utilization Management Barriers . . .