Dooyoung Lim1, Jeah Jung1. 1. Dr. Lim is with the Department of Public Health, Des Moines University, Des Moines, Iowa. Dr. Jung is with the Department of Health Policy and Administration, Pennsylvania State University, University Park.
Abstract
OBJECTIVE: The objective of this study was to examine whether and to what extent racial-ethnic differences exist in off-label use of antidepressant drugs by insurance type (Medicare, Medicaid, private coverage, and uninsured). METHODS: Multiyear data (2000-2010) from Medical Expenditure Panel Surveys were used. Logistic and negative binomial regressions were used for the likelihood and frequency analyses, respectively. RESULTS: The likelihood of filling prescriptions for off-label use of antidepressants was greater among blacks than among whites in all insurance groups (Medicare [N=6,470], adjusted odds ratio [AOR]=1.68; Medicaid [N=3,076], AOR=1.76; private coverage [N=9,918], AOR=2.10; and uninsured [N=1,826], AOR=1.88). Only in the uninsured group were Hispanics more likely than whites to use antidepressants off label (AOR=1.58). Among off-label antidepressant users, blacks and Hispanics with private coverage filled significantly fewer off-label antidepressant prescriptions than whites (blacks, incidence rate ratio [IRR]=.81; Hispanics, IRR=.88). CONCLUSIONS: Off-label use of antidepressants was more likely among blacks than among whites in all insurance groups; however, once whites initiated off-label use of antidepressants, they tended to fill off-label antidepressant prescriptions more frequently than blacks or Hispanics. Because off-label use may be inappropriate, clinical and policy efforts should aim to reduce off-label antidepressant use, with particular attention to racial-ethnic differences.
OBJECTIVE: The objective of this study was to examine whether and to what extent racial-ethnic differences exist in off-label use of antidepressant drugs by insurance type (Medicare, Medicaid, private coverage, and uninsured). METHODS: Multiyear data (2000-2010) from Medical Expenditure Panel Surveys were used. Logistic and negative binomial regressions were used for the likelihood and frequency analyses, respectively. RESULTS: The likelihood of filling prescriptions for off-label use of antidepressants was greater among blacks than among whites in all insurance groups (Medicare [N=6,470], adjusted odds ratio [AOR]=1.68; Medicaid [N=3,076], AOR=1.76; private coverage [N=9,918], AOR=2.10; and uninsured [N=1,826], AOR=1.88). Only in the uninsured group were Hispanics more likely than whites to use antidepressants off label (AOR=1.58). Among off-label antidepressant users, blacks and Hispanics with private coverage filled significantly fewer off-label antidepressant prescriptions than whites (blacks, incidence rate ratio [IRR]=.81; Hispanics, IRR=.88). CONCLUSIONS: Off-label use of antidepressants was more likely among blacks than among whites in all insurance groups; however, once whites initiated off-label use of antidepressants, they tended to fill off-label antidepressant prescriptions more frequently than blacks or Hispanics. Because off-label use may be inappropriate, clinical and policy efforts should aim to reduce off-label antidepressant use, with particular attention to racial-ethnic differences.
Authors: Eric M Bomberg; Elise F Palzer; Kyle D Rudser; Aaron S Kelly; Carolyn T Bramante; Hilary K Seligman; Favour Noni; Claudia K Fox Journal: Ther Adv Endocrinol Metab Date: 2022-04-11 Impact factor: 4.435