Antidepressant use and costs among low-education and low-income people with serious psychological distress: evidence from healthcare reform.

Objective The goal of this study was to assess the likelihood of purchasing antidepressants, number of antidepressants purchased, and out-of-pocket ( OOP) and total spending on antidepressants among people living with serious psychological distress ( SPD) from 2008 to 2014. Methods Data source: Medical Expenditure Panel Survey (MEPS) Data for the years from 2008 to 2014. Sample Design: A retrospective cross-sectional design was employed. MEPS is a nationally representative survey of the civilian, noninstitutionalised population in the U.S. The subset of individuals with serious psychological distress ( SPD) who used any antidepressant in the study period was 2401. Measurements: The study uses an established cut-off for serious psychological distress of a Kessler-6 score of ≥13. The Anderson Health Behavior model is used to select covariates. Data analysis: We calculated the mean number of scripts purchased, odds of any purchase, OOP, third-party and total payments for prescription antidepressants among people with SPD using Stata 14. Key findings The number of scripts purchased per person remained relatively stable between 2008 and 14. The odds of purchasing scripts were higher for Caucasian women, and were significantly lower for African Americans and people who spoke a language other than English at home. There was a significant decline in OOP among near poor, low-income and low-educational attainment people in 2014. Conclusions Evidence suggests that low-income, low-educational attainment people with SPD benefitted from health reform initiatives in the form of lower OOP in 2014. Maintenance of policies that enable insurance coverage of these people may have a role in ensuring access to needed antidepressants. [ABSTRACT FROM AUTHOR]