Medical Expenditure Panel Survey Agency for Healthcare 

Research and Quality

STATISTICAL BRIEF #163 

February 2007 

Trends in the Use and Expenditures 

for the Therapeutic Class Prescribed 

Psychotherapeutic Agents and All 

Subclasses, 1997 and 2004 

Highlights 

 Total expenditures in 2004 were 

at least 2.5 times as high as in

1997 for prescribed psychotherapeutic agents, increasing 

from $7.9 billion in 1997 to $20.0 

billion in 2004.

 From 1997 to 2004, for the subclasses within the therapeutic 

class of psychotherapeutic 

agents, total expenses approximately tripled for CNS stimulants (from $0.6 to $1.7 billion) 

and antipsychotics (from $1.3 to 

$4.1 billion) and approximately 

doubled for anxiolytics, sedatives, and hypnotics (from $0.9 

to $2.1 billion) and antidepressants (from $5.1 to $12.1 billion).

 Total prescribed medicine purchases for the therapeutic class 

of psychotherapeutic agents increased substantially from 1997

to 2004 (from 141.9 to 244.3 million), as they did for two subclasses within that class (CNS

stimulants, from 11.8 to 19.7 

million, and antidepressants, 

from 88.3 to 161.2 million). 

 When comparing 1997 and 

2004, the total number of people 

purchasing at least one prescribed medicine increased for 

the therapeutic class of psychotherapeutic agents (from 21.0 to 

32.6 million) and for all subclasses within it (anxiolytics, 

sedatives, and hypnotics, from 

5.4 to 7.9 million; CNS stimulants, from 2.1 to 3.3 million; 

antidepressants, from 15.3 to 

24.8 million; and antipsychotics, 

from 2.2 to 3.4 million). 

 When comparing all subclasses 

within the therapeutic class of 

psychotherapeutic agents from 

1997 to 2004, the average price 

per purchase increase was the 

greatest for antipsychotics, 

which more than doubled, rising

from $76.10 to $168.20. 

Marie N. Stagnitti, MPA 

Introduction 

This Statistical Brief compares 1997 and 2004 data for the U.S. 

civilian noninstitutionalized (community) population from the 

Household Component of the Medical Expenditure Panel Survey 

(MEPS-HC) on total expenditures, total number of purchases, total 

number of people with a purchase, and average price per purchase

for the therapeutic class of prescribed psychotherapeutic agents 

and all therapeutic subclasses within the class. The subclasses

include antipsychotics; central nervous system (CNS) stimulants; 

antidepressants; and anxiolytics, sedatives, and hypnotics. 

Only prescribed medicines purchases in an outpatient setting are 

included in the estimates presented in this brief. Insulin and 

diabetic supplies and equipment are included in MEPS prescribed 

medicines estimates. Over-the-counter medicines are excluded 

from these estimates as are prescription medicines administered in 

an inpatient setting or in a clinic or physician’s office. Expenditures 

are in nominal dollars. All differences discussed in the text are 

statistically significant at the 0.05 level. 

Findings 

Therapeutic class of psychotherapeutic agents 

In 2004, total expenditures on prescribed psychotherapeutic agents 

was at least 2.5 times as high as in 1997, rising from $7.9 billion to 

$20.0 billion (figure 1). In the same time span, the total number of 

purchases of psychotherapeutic agents increased substantially 

from 141.9 million purchases to 244.3 million purchases (figure 2). 

The total number of persons reporting purchasing a psychotherapeutic medicine rose from 21.0 million people to 32.6 million people

(figure 3). Finally, from 1997 to 2004, the average per purchase 

drug expenditure for a psychotherapeutic agent increased from

$55.80 to $82.00 (figure 4). 

Therapeutic subclass of antidepressants 

From 1997 to 2004, total expenditures on antidepressants more 

than doubled, rising from $5.1 billion to $12.1 billion (figure 1). The

total number of purchases of antidepressants rose from 88.3 
million purchases to 161.2 million purchases (figure 2), and the total number of persons reporting 

purchasing an antidepressant increased from 15.3 million people to 24.8 million people in the same time 

span (figure 3). Finally, the average per purchase drug expenditure for an antidepressant rose from 

$57.50 to $74.80 (figure 4). 

Therapeutic subclass of antipsychotics 

From 1997 to 2004, total expenditures on prescribed antipsychotics tripled, rising from $1.3 billion to

$4.1 billion (figure 1). In the same time span, the total number of purchases of antipsychotics increased

from 17.4 million purchases to 24.5 million purchases, and the total number of persons reporting 

purchasing an antipsychotic medicine rose from 2.2 million people to 3.4 million people (figure 2 and

figure 3). Finally, the average per purchase drug expenditure for an antipsychotic more than doubled, 

going from $76.10 to $168.20 (figure 4). 

Therapeutic subclass of anxiolytics, sedatives, and hypnotics 

From 1997 to 2004, total expenditures on prescribed anxiolytics, sedatives, and hypnotics doubled, going 

from $0.9 billion to $2.1 billion (figure 1). In the same time span, the total number of purchases of 

anxiolytics, sedatives, and hypnotics increased from 24.5 million purchases to 39.0 million purchases 

(figure 2); whereas the total number of persons reporting purchasing an anxiolytic, sedative, or hypnotic 

medicine increased from 5.4 million people to 7.9 million people (figure 3). Finally, the average per 

purchase drug expenditure for a drug in the anxiolytics, sedatives, and hypnotics therapeutic subclass 

increased from $36.70 to $55.10 (figure 4). 

Therapeutic subclass of CNS stimulants 

From 1997 to 2004, total expenditures on CNS stimulants nearly tripled, rising from $0.6 billion to $1.7 

billion (figure 1). Over the same period, the total number of purchases of CNS stimulants increased 

substantially, from 11.8 million purchases to 19.7 million purchases (figure 2), and the total number of 

persons purchasing at least one CNS stimulant increased from 2.1 million people to 3.3 million people 

(figure 3). Finally, the average per purchase drug expenditure for a CNS stimulant purchase rose from 

$52.40 to $87.80 (figure 4). 

Definitions/Methodology 

Therapeutic class and subclass were assigned to MEPS prescribed medicines using Multum Lexicon 

variables from Cerner Multum, Inc. MEPS prescribed medicines files were linked to the Multum Lexicon 

database to obtain therapeutic class and subclass variables. All psychotherapeutic agents in MEPS were 

defined as those events assigned the therapeutic class (TC1=242) in the Multum Lexicon database. In 

the Multum Lexicon database, all prescribed medicines assigned the psychotherapeutic class were 

further assigned one of the following subclasses: antidepressants (TC1S1=249); antipsychotics 

(TC1S1=251); anxiolytics, sedatives, and hypnotics (TC1S1=67); and CNS stimulants (TC1S1=71). For 

additional information on these and other Multum Lexicon variables, as well as the Multum Lexicon 

database itself, please refer to the following Web site: http://www.multum.com/Lexicon.htm. 

Use was defined as one or more purchases of a prescribed medicine in a therapeutic class or subclass of 

interest. Individuals were classified as using a prescribed medicine of interest if they had one or more 

purchases of a drug in a class or subclass of interest during the year. 

Expenditures are in nominal dollars. 

Insulin and diabetic supplies and equipment are included in MEPS total prescribed medicines estimates. 

About MEPS-HC 

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health 

care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, 

demographic, and economic characteristics for the civilian noninstitutionalized population. It is cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health Statistics. 

For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1656) or 

visit the MEPS Web site at http://www.meps.ahrq.gov/. 
References 

For a detailed description of the MEPS survey design, sample design, and methods used to minimize 

sources of nonsampling error, see the following publications: 

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care,

July 2003: 41(7) Supplement: III-5–III-12. 

Suggested Citation 

Stagnitti, M. N. Trends in the Use and Expenditures for the Therapeutic Class Prescribed 

Psychotherapeutic Agents and All Subclasses, 1997 and 2004. Statistical Brief #163. February 2007. 

Agency for Healthcare Research and Quality, Rockville, MD. http://www.meps.ahrq.gov/mepsweb/ 

data_files/publications/st163/stat163.pdf 

∗ ∗ ∗

AHRQ welcomes questions and comments from readers of this publication who are interested in 

obtaining more information about access, cost, use, financing, and quality of health care in the United 

States. We also invite you to tell us how you are using this Statistical Brief and other MEPS data and 

tools and to share suggestions on how MEPS products might be enhanced to further meet your needs. 

Please e-mail us at mepspd@ahrq.gov or send a letter to the address below: 

Steven B. Cohen, PhD, Director 

Center for Financing, Access, and Cost Trends 

Agency for Healthcare Research and Quality 

540 Gaither Road 

Rockville, MD 20850 
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

1997 and 2004

4.1

2.1

0.9

0.6

1.3

5.1

7.9

20.0

1.7

12.1

0

10

20

Psychotherapeutics Antidepressants Antipsychotics Anxiolytics,

sedatives, and

hypnotics

CNS stimulants

1997 2004

N

o

minal d

ollars in billions

Figure 1. Total expenditures for the therapeutic class

prescribed psychotherapeutic medicines 

and all subclasses, 1997 and 2004

Note: Total prescribed medicines expenditures in 1997 were $72.3 billion and rose to 191.0 billion in 2004.

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

1997 and 2004

24.5

39.0

24.5

11.8 17.4

88.3

141.9

244.3

19.7

161.2

0

100

200

300

Psychotherapeutics Antidepressants Antipsychotics Anxiolytics,

sedatives, and

hypnotics

CNS stimulants

1997 2004

Number of purchases in millions

Figure 2. Total number of purchases for the 

therapeutic class prescribed psychotherapeutic

medicines and all subclasses, 1997 and 2004

Note: Total prescribed medicines purchases in 1997 were 1,873.7 million and rose to 2,936.1 million in 2004.

Statistical Brief #163: Trends in the Use and Expenditures for the Therapeutic Class Prescribed Psychotherapeutic 

Agents and All Subclasses, 1997 and 2004
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

1997 and 2004

3.4

7.9

5.4

2.1 2.2

15.3

21.0

32.6

3.3

24.8

0

10

20

30

40

Psychotherapeutics Antidepressants Antipsychotics Anxiolytics,

sedatives, and

hypnotics

CNS stimulants

1997 2004

Number of people in millions

Figure 3. Total number of people with purchases 

of therapeutic class prescribed psychotherapeutic

medicines and all subclasses, 1997 and 2004

Note: Total number with a prescribed medicine purchase in 1997 was 168.5 million and rose to 184.1 million in 2004.

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

1997 and 2004

168.20

55.10

36.70

52.40

76.10

57.50 55.80

82.00

87.80

74.80

0

100

200

Psychotherapeutics Antidepressants Antipsychotics Anxiolytics,

sedatives, and

hypnotics

CNS stimulants

1997 2004

N

o

minal d

ollars

Figure 4. Mean expenditure for therapeutic class 

prescribed psychotherapeutic medicines 

and all subclasses, 1997 and 2004

Note: The mean expenditure for all prescribed medicines in 1997 was $38.50 and rose to $65.00 in 2004.

Statistical Brief #163: Trends in the Use and Expenditures for the Therapeutic Class Prescribed Psychotherapeutic 

Agents and All Subclasses, 1997 and 2004