Depression and Anxiety Medication Research

Part
01
of three
Part
01

Depression and Anxiety Medication: Insurance Telehealth Claims

Requirements by legislation to increase access to mental health services have contributed to increased acceptance of depression/mental health telehealth claims by insurance companies, while non-compliance by providers is one of the reasons for the rejection of depression/mental health telehealth claims by insurance companies.

Acceptance of Mental Telehealth Claims by Insurance Companies

  • According to a white paper by Fair Health, private insurance claims for telehealth services have increased more than 1,200% from 2012 to 2017, Fair Health's data shows.
  • The paper also indicates that mental health topped the telehealth utilization list in 2016, but was fifth in 2017 at 7% of all telehealth claims.
  • One of the motivations behind accepting telehealth claims for mental health is to encourage the use of telehealth as a cheaper and more convenient means to access care.
  • Insurance programs like Medicare & Medicaid are accepting telehealth claims, although, this is restricted to claims from professionals that practice in accountable care organizations (ACOs).
  • In June 2018, the Centers for Medicare & Medicaid Services (CMS) publicly encouraged states to utilize telemedicine and telepsychiatry to facilitate coordinated care for Medicaid recipients.
  • Many health plans today cover and accept telemental health claims. This is partly because they are mandated by more than half of the U.S. states to ensure mental health parity; more so, the Affordable Care Act encourages this trend through its focus on accessible and affordable health care.
  • BCBS of Alabama expanded its claims acceptance into telehealth for mental health claims citing that the technology used to treat mental health was “indistinguishable from a face-to-face visit.”

Rejection of Mental Telehealth Claims by Insurance Companies

  • According to the report, "Telehealth Delivery of Mental Health Services: An Analysis of Private Insurance Claims Data in the United States',' telehealth claims for mental health are a small proportion of total claims, and average reimbursements for these claims are substantially lower than those for comparable non-telehealth services.
  • According to a report to Congress, "an analysis of physician claims for Medicare services suggests that some portion of telehealth claims are supplemental rather than a substitute for in-person services."
  • Some insurance companies reject depression/mental health telehealth claims from providers because of compliance issues. Providers who fail to comply with requirements as per individual state regulations often miss out out on reimbursement.
  • Lack of clarity in the services for which claims are made by practitioners has also contributed to many cases of claims rejection by insurance companies.
  • Under Medicare’s restrictive telehealth policy, it will reject claims from physicians and practitioners who issue prescriptions to patients without having a physical or mental health status examination to establish a provider-patient relationship.

Legislation Impacting the Acceptance of Mental Telehealth Claims by Insurance Companies

  • The Mental Health Parity Compliance Act 2019 is currently in progress in Congress; it is an improvement on the Mental Health Parity Act that has to a larger extent encouraged the acceptance of telehealth claims among insurance companies. The legislation requires a plan's coverage for behavioral health treatment to be on par with its coverage for medical-surgical treatment.
  • The Bipartisan Budget Act of 2018 signed into law in February 2018, encourages insurers to accept claims for tele-mental health services.
  • The Mental Health Telemedicine Expansion Act (HR 1301) was re-introduced to Congress in February 2019; if passed, it would enable the acceptance of claims by Centers for Medicare & Medicaid Services from providers for home-based telemental health.


Part
02
of three
Part
02

Depression and Anxiety Medication: Part I

Commonly prescribed medications for treating depression or anxiety include: Prozac, Zoloft, Celexa, Desyrel, Lexapro, Valium, Cymbalta, Paxil and Luvox.

Commonly Prescribed Depression and Anxiety Medications

1. Prozac

  • Prozac is an antidepressant that is mainly used to treat major depression, obsessive-compulsive disorder, and panic disorders.
  • Prozac is a brand name while its generic form is known as Fluoxetine.

2. Zoloft

  • Zoloft is an antidepressant that belongs to a group of drugs known as selective serotonin reuptake inhibitors (SSRIs).
  • Zoloft is used to treat depression, obsessive-compulsive disorder, panic disorder, anxiety disorders, post-traumatic stress disorder (PTSD).
  • Zoloft's is a brand name while its generic name is sertraline.

3. Celexa

  • Celexa is an antidepressant in the class of selective serotonin reuptake inhibitor (SSRI) and usually prescribed for to treat major depressive disorders.
  • Celexa is the brand name of a generic drug called citalopram.

4. Desyrel

5. Lexapro

  • Lexapro is an orally-administered antidepressant in the class of selective serotonin reuptake inhibitors (SSRIs).
  • Lexapro is the brand name of the generic drug known as escitalopram oxalate.

6. Cymbalta

  • Cymbalta is a selective serotonin and norepinephrine reuptake inhibitor (SNRI) and while it is often prescribed to treat depression and anxiety disorders, it is also used to treat pain from fibromyalgia or diabetic peripheral neuropathy.
  • Cymbalta is the brand name of a generic drug known as duloxetine.

7. Valium

  • Valium is a benzodiazepine that is used to treat anxiety and depression, but it is also prescribed to treat seizures, muscle spasms, and symptoms associated with alcohol withdrawal.
  • Valium is the brand name of a generic drug known as diazepam.

8. Paxil

  • Paxil is an antidepressant medication that is used for the treatment of generalized anxiety disorder (GAD) and other anxiety disorders.
  • It was developed as a treatment for depression and belongs to the SSRI class of drugs.
  • Paxil is the brand name of a generic drug known as paroxetine.

9. Luvox

Part
03
of three
Part
03

Depression and Anxiety Medication: Part II

Ten commonly prescribed medications for treating depression and anxiety are Wellbutrin, Sarafem, Pexeva, Pristiq, Khedezla, Fetzima, Effexor XR, Anafranil, Norpramin, and Trofanil.

WELLBUTRIN

  • Wellbutrin is dopamine reuptake blocker that is used to treat depression and seasonal affective disorder. It is also prescribed for smoking cessation as well.
  • Wellbutrin is the brand name for the generic drug, bupropion.

SARAFEM

PEXEVA

PRISTIQ

KHEDEZLA

FETZIMA

EFFEXOR XR

  • Effexor XR is in the SNRI class of drugs and is used to treat depression, panic attacks, anxiety, and social anxiety disorder.
  • Effexor XR is the brand name of the generic drug, venlafaxine.

ANAFRANIL

NORPRAMIN

  • Norpramin is a tricyclic antidepressant that is often used to treat depression when SSRIs have not been effective.
  • Norpramin is the brand name and desipramine is the generic name.

TROFANIL

RESEARCH STRATEGY

The most commonly prescribed medications for treating depression or anxiety were presented in part one. Therefore, to provide 10 additional medications, we had to select those that are prescribed less often, but are still listed by Healthline as common treatments. These are not ranked in any way, but according to Healthline, the SSRIs and SNRIs are more commonly prescribed than the tricyclic antidepressants on the list.
Sources
Sources

From Part 02
Quotes
  • "Every day, one out of six Americans takes a psychiatric medication, according to a 2017 study published in the Journal of the American Medical Association (JAMA). "
  • "The most commonly used antidepressants in the study were: - Sertraline hydrochloride (Zoloft) - Citalopram hydrobromide (Celexa) - Fluoxetine hydrochloride (Prozac) - Trazodone hydrochloride (Desyrel) - Escitalopram oxalate (Lexapro) - Duloxetine hydrochloride (Cymbalta)"
Quotes
  • "Prozac is an antidepressant. It is mainly used to treat major depression, obsessive-compulsive disorder, and panic disorder. Also known by its generic name, fluoxetine, Prozac is a selective serotonin reuptake inhibitor (SSRI). Around 1 in 10 people in the United States (U.S.) are thought to use SSRI drugs, and 1 in 4 women in their 40s and 50s."