Off-Label Policy Through the Lens of Trazodone Usage and Spending in the United States

• In Event: Innovation, Incentives, and Inefficiencies in Pharmaceutical Markets

Abstract

Trazodone is a medication that received FDA approval for the treatment of major depressive disorder in 1981. Although only approved for the treatment of depression, trazodone is often prescribed off-label for indications of uncertain value (insomnia, anxiety). We use data from the 2019 Medical Expenditure Panel Survey to characterize on-label and off-label utilization and health care spending (health plan and Out-of-Pocket) on trazodone. We found that approximately 24 million prescriptions were filled for trazodone at a total cost of $294 million in 2019. We estimate that at a minimum, 85% of utilization (~20 million prescriptions) and 84% of total health care spending ($247 million) was for off-label indications, primarily insomnia. Using prescription level data, we also show that on-label and off-label health plan reimbursement per trazodone prescription is nearly identical.  These findings suggest policy solutions aimed at supporting a more efficient system of off-label utilization. 

 

 

Authors

• Srikanth Kadiyala, University of California - Los Angeles
  Presenting Author

• Matthew Chenoweth, University of California - Los Angeles
  Non-Presenting Co-Author