Top 10 Conditions by Resource Use. Rank by Total Resource Use*
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1 Table 1 Top 10 Conditions by Resource Use Condition Rank by Total Resource Use* Total Resource Use Resource Use per Enrollee Depression & Mental Health 1 $2,332,695,279 $863 Other Infections and Inflammatory Disease of Central Nervous System 2 $653,134,818 $242 Chronic Renal Failure, End Stage Renal Disease 3 $644,093,224 $238 Pregnancy 4 $619,681,168 $229 Neonates 5 $495,939,913 $183 Diabetes 6 $492,797,188 $182 Back and Spine, Pain or Condition 7 $478,815,042 $177 Drug Dependence 8 $422,386,839 $156 Fractures and Dislocations 9 $377,534,141 $140 Infections/Inflammations of the Gastrointestinal System 10 $353,680,124 $131 Based on 2,704,481 Wisconsin Medicaid Enrollees Claims ARE NOT grouped into episodes of care for this *Resource Use is a normalized pricing of all services and administrative data driven by the type of service assigned to a medical or pharmacy service: Inpatient Facility Services: Acute or Rehab/Skilled Nursing Facility Admissions Outpatient Facility Services: Outpatient Lab, Emergency Room, Radiology, Surgery Professional & Ancillary Services: Office Visits, Drugs Administered (Injectables), Durable Medical Equipment Pharmacy Services: Retail-based services with Nation Drug Codes
2 Figure 1 $2,500,000,000 $2,332,695,279 Total Resource Use Total Resource Use $2,000,000,000 Resource Use $1,500,000,000 $1,000,000,000 $500,000,000 $653,134,818 $644,093,224 $619,681,168 $495,939,913 $492,797,188 $478,815,042 $422,386,839 $377,534,141 $353,680,124 $0 Depression & Mental Health Other Infections and Inflammatory Disease of Central Nervous System Chronic Renal Failure, End Stage Renal Disease Pregnancy Neonates Condition Diabetes Back and Spine, Pain or Condition Drug Dependence Fractures and Dislocations Infections/Inflammations of the Gastrointestinal System Claims ARE NOT grouped into episodes of care for this analysis
3 Figure 2 Medicaid Resource Use Depression, $449,909,452, 2.86% Mental Health (Other), $1,984,486,002, 12.63% ADD, $306,850,147, 1.95% Of the $15,706,664,838 in Resource Use under Medicaid in the WHIO database, 17.5% is used on Mental Health episodes of care. ($2,741,245,601) All Other Conditions, $12,965,419,238, 82.55%
4 Figure 3 Attention Deficit Disorder In the treatment of Attention Deficit Disorder, roughly two-thirds of the costs are pharmacy costs ($203,541,400 out of $306,850,147). All Other Costs, $103,308,747, 33.67% Pharmacy Costs, $203,541,400, 66.33% Top 5 Drugs Prescribed for Attention Deficit Disorder Drug Prescriptions Resource Use Number of ADD Episodes Dextroamphetamine & amphetamine aspartate or sulfate, extended-release 260,046 $64,724,372 Dextroamphetamine & amphetamine aspartate or sulfate 198,063 $16,581,148 Lisdexamfetamine dimesylate 164,669 $36,188,870 Methylphenidate hydrochloride, extended-release 163,885 $36,484,717 Methylphenidate hydrochloride 64,324 $3,292, ,232
5 Figure 4 Depression Pharmacy Costs, $76,397,228, 16.98% In the treatment of Depression, about 17% of the costs are pharmacy costs ($76,397,228 out of $449,909,452). All Other Costs, $373,512,224, 83.02% Top 5 Drugs Prescribed for Depression Drug Prescriptions Resource Use Sertraline hydrochloride 135,541 $1,744,173 Fluoxetine hydrochloride 123,736 $2,131,022 Bupropion, various, except zyban 123,070 $5,953,144 Gabapentin 109,773 $3,234,352 Alprazolam 105,716 $548,738 Number of Depression Episodes 201,194
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