Browsing Theses and Dissertations School of Pharmacy by Title "Impact of Food and Drug Administration pediatric antidepressant use warnings on treatment of depression, physician specialty practice patterns, and pharmaceutical stock prices"
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Impact of Food and Drug Administration pediatric antidepressant use warnings on treatment of depression, physician specialty practice patterns, and pharmaceutical stock pricesBackground: To investigate the impact of the FDA pediatric antidepressant warning in March 2004 on: 1) the treatment of new-onset depression diagnosis (NODD); 2) physician specialty practice patterns; and 3) the stock returns of the antidepressant manufacturers. Methods: Youth 2-17 years old with a NODD from 2003-2006 constituted the study population. i3 Innovus database containing administrative claims information of U.S. commercial insurance enrollees was used. National Ambulatory Medical Care Survey data (2001-2006) were used to examine antidepressant use by physician specialty during youth mental health visits. CRSP stock price data (2003-2006) was used to examine the warning impact on stock returns and volatility. Results: The warnings led to a statistically significant decrease in the likelihood of antidepressant use [Odds Ratio (OR) =0.83; CI: 0.75,0.92] and an increase in the likelihood of psychotherapy in NODD but not a significant impact on youth with MDD. The likelihood of an antidepressant prescription was significantly higher for psychiatrist visits compared to primary care (OR=3.78; CI: 2.72,5.25). The warning was associated with a non-significant impact on the magnitude of stock returns but a significant increase in the volatility of stock returns (mean change = 0.30; CI: 0.10,0.49). Conclusions: The FDA warning did not lead to a A) decrease in the likelihood of antidepressant use for youth with a diagnosis of major depression, whereas psychotherapy use increased; B) increase the likelihood of antidepressant prescribing by psychiatrists relative to primary care; C) decrease in stock returns but only a modest increase in volatility of stock returns.