DBPNet Finds More Prescription of Psychotropic Medication for Young Children with ASD and Medicaid Compared to Private Insurance

PROGRAM: University of Washington PATHWAYS Project

December 18, 2017

The Developmental-Behavioral Pediatrics Research Network (DBPNet) is a 14 site Network whose mission is "to conduct collaborative, interdisciplinary research in developmental and behavioral pediatrics that advances clinical practice, supports research training, and optimizes the health and functional status of children with developmental and behavioral concerns and disorders, including children with autism spectrum disorders and other developmental disabilities".  

In the October issue of the Journal of Developmental and Behavioral Pediatrics (http://journals.lww.com/jrnldbp/Citation/2017/10000/Factors_Associated_with_Developmental_Behavioral.3.aspx) the Network reported the results of a study that used data from the electronic health record at 3 DBPNet sites to determine the factors that led developmental and behavioral pediatricians (DBPs) to prescribe psychotropic medications for children with ASD. The study found that DBPs were more likely to prescribe medications for behavior or emotions in children with ASD when the child was older and when the child had behavioral diagnoses in addition to ASD.  In addition, the study found that the type of insurance the child had (Medicaid vs. Private Insurance) was related to a difference in prescribing psychotropic medication in young children, but not older children.  Specifically, 3 to 5 year old children with Medicaid were more likely to be prescribed medication for behavior and emotions than were 3-5 year old children with private insurance.  The types of medications that were more likely to be prescribed to young children with ASD who had Medicaid insurance were atypical antipsychotics and alpha agonists.  This study did not determine why there is this disparity in prescribing these medications to young children with ASD, but multiple factors could contribute including: differences in when the groups seek health care, differences in behavioral expectations between groups, differences in access or quality of behavioral and educational treatments for ASD, physician bias in prescribing practices, and lower cost access to pharmacologic treatments in Medicaid than private insurance among others.