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Medicaid’s Prior Authorization Program And Access To Atypical Antipsychotic Medications
Jennifer M. Polinski, Philip S. Wang, Michael A. Fischer. Health Affairs, 2007-05-01
Topic: Risk, prevention and care in population studies
State Medicaid programs use prior authorization (PA) to control drug spending by requiring that specific conditions be met before allowing reimbursement. The extent to which PA policies respond to new developments concerning medication safety is not known. In April 2005 the Food and Drug Administration (FDA) issued an advisory describing increased mortality among elderly people with dementia taking atypical antipsychotics. More than a year later, no state had changed its PA policy in response. We discuss the roles of Medicaid and other insurers in responding to emerging drug safety issues and their challenges in weighing drug risks and benefits.
Key findings
- State Medicaid programs use prior authorization (PA) to control drug spending by requiring that specific conditions be met before allowing reimbursement.
- The extent to which PA policies respond to new developments concerning medication safety is not known.
- In April 2005 the Food and Drug Administration (FDA) issued an advisory describing increased mortality among elderly people with dementia taking atypical antipsychotics.
- More than a year later, no state had changed its PA policy in response.
- We discuss the roles of Medicaid and other insurers in responding to emerging drug safety issues and their challenges in weighing drug risks and benefits.
Why it matters
This paper reports that more than a year after the FDA advisory about increased mortality among elderly people with dementia taking atypical antipsychotics, no state Medicaid program had changed its prior authorization policy in response. It discusses the challenges insurers face in responding to emerging drug safety issues.
Study details
- Evidence strengthLow
How this study scored 38/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Health Affairs) |
| Journal's citation record | 3 / 4 | Health Affairs: journal h-index 277 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2007 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 46 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.2 citations a year over 21 year(s) since 2007 |
| Impact for its field and year | 4 / 6 | Cited 15.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Michael A. Fischer: h-index 56 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Brigham and Women's Hospital: institution h-index 1,995 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 17485754) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 38 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Polinski, J. M., Wang, P. S., & Fischer, M. A. (2007). Medicaid’s Prior Authorization Program And Access To Atypical Antipsychotic Medications. Health Affairs. https://doi.org/10.1377/hlthaff.26.3.750
Vancouver
Polinski JM, Wang PS, Fischer MA. Medicaid’s Prior Authorization Program And Access To Atypical Antipsychotic Medications. Health Affairs. 2007. doi:10.1377/hlthaff.26.3.750. PMID: 17485754.
BibTeX
@article{polinski2007-17485754,
author = {Polinski, Jennifer M. and Wang, Philip S. and Fischer, Michael A.},
title = {{Medicaid’s Prior Authorization Program And Access To Atypical Antipsychotic Medications}},
journal = {Health Affairs},
year = {2007},
doi = {10.1377/hlthaff.26.3.750},
pmid = {17485754},
url = {https://doi.org/10.1377/hlthaff.26.3.750}
}
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.