MANAGED CARE AND MEDICATION COMPLIANCE - IMPLICATIONS FOR CHRONIC DEPRESSION

An emerging trend within managed care, ''disease management'' (DM), wi ll affect consumers and providers of mental health services, clinician s, and mental health administrators. Central to DM programs is the ide a that particular diseases, especially chronic illnesses (including de pression), can be ''carved out'' and managed. Pharmaceutical benefit m anagement (PBM) firms may specialize in managing prescription benefits for employers and other managed care organizations by using DM progra ms. However given what is known from the theoretical and empirical lit erature on adherence to medication for chronic illnesses such as depre ssion, it is questionable whether the techniques that are used by PBMs will be effective in managing illnesses that require a multifaceted a pproach to care. Because the management of antidepressants may have an impact on members of vulnerable populations (e.g., the elderly), more research is required on the approaches used by PBMs and on the cost a nd quality of the services provided.