# Association between a publicly funded universal drug program and antipsychotic and antidepressant medication dispensing to children

## TL;DR

A publicly funded drug program in Ontario did not significantly change the rate of antidepressant or antipsychotic prescriptions for children.

## Contribution

This study evaluates the impact of a universal pharmacare policy on medication dispensing trends for children.

## Key findings

- OHIP+ implementation showed no significant change in antidepressant dispensing rates.
- The program's revision had no significant effect on antipsychotic dispensing trends.
- Policy changes did not alter medication dispensing for children overall.

## Abstract

The prescribing of antidepressants and antipsychotics to children has increased worldwide, but little is known about how changes in drug funding policy influence the practice. In 2018, Ontario introduced a universal pharmacare program (OHIP+) for children and youth, amending it in April 2019 to cover only those without private insurance. We examined the association of these policy changes with antipsychotic and antidepressant medication prescribing.

We conducted a population-based study of antidepressant and antipsychotic medication dispensing to children ≤ 18 years old between September 1, 2014, and February 29, 2020. We obtained dispensing data from the IQVIA Geographic Prescription Monitor database, and used interventional autoregressive integrated moving average models to examine whether the implementation of OHIP + and its subsequent revision were associated with changes in dispensing.

The implementation of OHIP + was not associated with changes in the rate of antidepressants (-19.3 units per 1,000 population; 95% confidence interval [CI]: -41.7 to 3.1) or antipsychotics (+ 1.0 unit per 1,000 population; 95% CI: -5.4 to 7.5) dispensed. Similarly, subsequent changes to the program restricting coverage to children without private insurance were not associated with antidepressant (0.3 units per 1,000; 95% CI: -7.4 to 7.9) or antipsychotic (1.0 units per 1,000; 95% CI: -0.9 to 2.9) dispensing trends.

Implementation of a publicly-funded pharmacare program did not influence trends in antidepressant or antipsychotic medication dispensing among children.