Managed care and medication compliance: implications for chronic depression

Area of Science:

• Health Services Research
• Mental Health Management
• Pharmaceutical Policy

Background:

• Managed care is increasingly adopting disease management (DM) strategies.
• DM programs aim to manage specific chronic illnesses, such as depression, by "carving out" care.
• Pharmaceutical benefit management (PBM) firms often implement these DM programs for prescription benefits.

Purpose of the Study:

• To evaluate the effectiveness of PBM-driven disease management techniques for chronic illnesses like depression.
• To examine the potential impact of these approaches on vulnerable populations, including the elderly.
• To highlight the need for further research into the cost and quality of PBM services.

Main Methods:

• Review of theoretical and empirical literature on medication adherence for chronic illnesses.
• Analysis of disease management (DM) program structures utilized by pharmaceutical benefit management (PBM) firms.
• Consideration of the multifaceted nature of care required for conditions like depression.

Main Results:

• Existing PBM techniques may be insufficient for managing complex, chronic conditions like depression.
• The efficacy of current DM approaches in ensuring medication adherence for depression is questionable.
• Potential negative impacts on vulnerable patient groups necessitate further investigation.

Conclusions:

• Disease management programs, particularly those managed by PBMs, may not be optimally suited for treating depression.
• Further research is crucial to assess the cost-effectiveness and quality of care provided by PBMs.
• Special attention is needed to understand the impact on vulnerable populations and ensure comprehensive mental health management.