Youth Medicaid beneficiaries in Colorado had medication costs of $1.1 billion, with 47% of costs attributed to the 6% of youth taking five or more medications, according to data from the 2022 Colorado All Payer Claims Database. The remaining 53% of costs were attributed to the 94% of youth taking fewer medications concurrently. Of the 529,055 youth Medicaid beneficiaries that year who were prescribed one or more medications, about 6% were taking five or more concurrently, which was defined as a high level of polypharmacy. About 44% were taking two-to-four medications concurrently, and 50% were taking only one medication.
Compared to youth taking only one medication, those taking five or more medications were more likely to be female and more likely to be between ages 13 and 21. Youth taking five or more medications were more likely to have a complex chronic health condition, and they had more inpatient, emergency, and outpatient visits than youth taking only one medication.
These findings were reported in Annual Medication Use and Costs Among Children by Anowara Begum, MPH; Patrick Hosokawa, MS; Lucas E. Orth, PharmD; and James A. Feinstein, M.D., MPH. The researchers analyzed data from the 2022 Colorado All Payer Claims Database. The data set included 529,055 youth ages 1 to 21 years who were prescribed one or more medications. The researchers defined the polypharmacy level by the number of concurrently used medications, ranging from no polypharmacy (one medication), low polypharmacy (two-to-four medications), and high polypharmacy (five or more medications). About 50% of the youth had no polypharmacy, 44% had low polypharmacy, and 6% had high polypharmacy. The annual total medication costs were calculated using the pharmacy’s price from a manufacturer.
The researchers sought to describe annual outpatient prescription medication use and costs among children. In a secondary analysis, they determined which children had polypharmacy costs that aligned with the requirements for qualifying for medication therapy management (MTM) provided to adult Medicare beneficiaries. The cost criteria were based on a threshold established Centers for Medicare and Medicaid Services. Adult Medicare beneficiaries who exceed an annual prescription cost threshold receive MTM consisting of a pharmacist-led comprehensive medication review, medication optimizations, and creation of a medication action plan. The researchers noted that MTM for adults has improved consumer safety and reduced medication spending, but no similar MTM interventions exist for children.
The full text of Annual Medication Use and Costs Among Children was published March 24, 2025, by JAMA Network Open. A free copy is available online at https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2831871 (accessed April 24, 2025).
For more information, contact: James Feinstein, M.D., MPH, Professor, Adult and Child Center for Outcomes Research and Delivery Science, University of Colorado, 1890 North Revere Court, 3rd Level, Mail Stop F443, Aurora, Colorado 80045; Email: james.feinstein@cuanschutz.edu; Website: https://medschool.cuanschutz.edu/accords/about/faculty-staff-directory/Feinstein-James-UCD36903
August 2025 00US25EUA0023