Studying Prescription Drug Use and Outcomes With Medicaid Claims Data

Medicaid claims and eligibility data, particularly when linked to other sources of patient-level and contextual information, represent a powerful and under-used resource for health services research on the use and outcomes of prescription drugs. However, their effective use poses many methodological and inferential challenges. This article reviews strengths, limitations, challenges, and recommended strategies in using Medicaid data for research on the initiation, continuation, and outcomes of prescription drug therapies. Drawing from published research using Medicaid data by the investigators and other groups, we review several key validity and methodological issues. We discuss strategies for claims-based identification of diagnostic subgroups and procedures, measuring and modeling initiation and persistence of regimens, analysis of treatment disparities, and examination of comorbidity patterns. Based on this review, we discuss "best practices" for appropriate data use and validity checking, approaches to statistical modeling of longitudinal patterns in the presence of typical challenges, and strategies for strengthening the power and potential of Medicaid datasets. Finally, we discuss policy implications, including the potential for the research use of Medicare Part D data and the need for further initiatives to systematically develop and optimally use research datasets that link Medicaid and other sources of clinical and outcome information

Alternative medicine · Data science · Health care · Identification (biology) · Medicaid · Medical prescription · MEDLINE · Outcomes research · Prescription drug · Advanced Causal Inference Techniques · Computer Science · Health Systems, Economic Evaluations, Quality of Life · Medication Adherence and Compliance · Medicine · Nursing

• Evidence of Sample Use Among New Users of Statins

  Xiaojuan Li, Til Stürmer et al.•Medical Care•2014

  Incluir item

• Characteristics of Medicaid Recipients Receiving Persistent Antipsychotic Polypharmacy

  Open Access•Robert O Cotes, David R Goldsmith et al.•Community Mental Health Journal•2018

  Incluir item

• Assessing the community clinic replacement effect on private Medicaid practices in oral health care within rural environments

  Open Access•Joe Squillace•Journal of Public Health Dentistry•2012

  Incluir item

• Structural and Social Determinants of Health Factors Associated with County-Level Variation in Non-Adherence to Antihypertensive Medication Treatment

  Open Access•Macarius Donneyong, Teng-Jen Chang et al.•International Journal of…•2020

  Incluir item

• Prevalence of diagnosed mental health conditions among US children with public and commercial insurance

  Open Access•W H Liu, Wanmeng Liu et al.•BMC Public Health•2025

  Incluir item

• Factors associated with treatment attrition for Medicaid-enrolled youth with serious emotional disturbances

  Open Access•Amy N Mendenhall, Cynthia A Fontanella et al.•Children and Youth Services Review•2014

  Incluir item

• Age, period and cohort-related trends in prescription opioid use in the USA, 1999–2018

  Kristin Y Shiue, Anna E Austin et al.•Journal of Epidemiology and…•2023

  Incluir item

• Identifying a Sample of HIV-Positive Beneficiaries From Medicaid Claims Data and Estimating Their Treatment Costs

  Arleen Leibowitz, Arleen A Leibowitz et al.•American Journal of Public Health•2015

  Incluir item

• Assessing Medication Exposures and Outcomes in the Frail Elderly

  Stephen Crystal, Dorothy Gaboda et al.•Medical Care•2010

  Incluir item

• Emerging Methods in Comparative Effectiveness and Safety

  Kathleen N Lohr•Medical Care•2007

  Incluir item

• Mental Comorbidity and Quality of Diabetes Care Under Medicaid

  Benjamin G Druss, Liping Zhao et al.•Medical Care•2012

  Incluir item

• The assessment of refill compliance using pharmacy records

  Open Access•J F Steiner, Allan V Prochazka•Journal of Clinical Epidemiology•1997

  Incluir item

• Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases

  Open Access•Richard A Deyo, R DEYO•Journal of Clinical Epidemiology•1992

  Incluir item

• A new method of classifying prognostic comorbidity in longitudinal studies

  Open Access•Mary E Charlson, Peter Pompei et al.•Journal of Chronic Diseases•1987

  Incluir item

• Sensitivity of an Aids Case-Finding Algorithm

  James Walkup, James T Walkup et al.•Medical Care•2004

  Incluir item

• Validity of a Prescription Claims Database to Estimate Medication Adherence in Older Persons

  Ruby Grymonpre, Mary Cheang et al.•Medical Care•2006

  Incluir item

• Mammography Self-Report and Mammography Claims

  Kathleen Holt, Peter Franks et al.•Medical Care•2006

  Incluir item