Richard Hansen, PhD — Helping Guide Medicaid Policies
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Richard Hansen, PhD — Helping Guide Medicaid Policies
Helping Guide Medicaid Policies
Hansen became interested in antidepressant adherence through his work with the RTI-UNC Evidence-Based Practice Center, a collaboration between UNC-Chapel Hill and the Research Triangle Institute. One of the studies he conducted was a review of antidepressants, which found that the newer drugs did not differ much in terms of efficacy.
“None of them are great; only about fifty percent of people benefit from them,” Hansen says. "When you compare them all side by side, there are not a lot of differences. So why is one drug used so much more frequently than another? What makes one drug work for someone and not for someone else? What are the real issues here when it comes to decision making for someone like a Medicaid payer?
“One of the big question marks that kept coming up was adherence. That’s why I really got interested in depression and in that drug class.”
Hansen has been working with the center since 2003, conducting comparison studies of drug classes. The research data helps guide state Medicaid programs, which contracted with the center, in their policy decisions.
“Over the last decades, state Medicaid programs have witnessed dramatic increases in prescription-drug spending,” Hansen says. “So in an effort to try to control the budget, they started implementing policies about which drugs people could use, how much they could use, how long they could use them. In some cases, those policies were made without having a clear understanding of the benefits and risks of the drugs. So the Medicaid programs started working together and contracted with a consortium of evidence-based practice centers to help them review the evidence that would help them make decisions.
“That way, when individual states are making decisions, their decisions are based on up-to-date evidence that’s grounded in science and not just the price tag of the drug.”
Hansen also conducts studies for the Agency for Health Care Research and Quality, a federal program that is interested in comparing the effectiveness of different drugs. The work is similar to what he does for the state Medicaid program, except on a larger and more complex scale because it affects a national program.