In January 2012, the Pennsylvania Department of Public Welfare implemented a limit on the number of monthly prescriptions for patients on Medicaid. An arbitrary limit of six prescriptions was chosen as a policy to save the state money.
Though there are some exceptions for chronic conditions like diabetes, cancer and heart disease, this policy severely limits my sickest patients from obtaining medications they need. Furthermore, physicians and patients are often unaware of the policy until their prescriptions are denied.
I agree on the need to limit growing medical costs, including cutting back on inappropriate prescribing. However, prescription limits have never been shown to improve patient care or decrease costs.
Studies have found costs actually increase as a result of increased hospital admissions and emergency-room visits by patients denied medications. Pennsylvania is no exception, and preliminary data on the limits recently released by the department clearly show an increasing number of emergency-room visits by patients denied medications.
The Medicaid prescription drug limit was designed to save the state money with the hope it would not impact patient care. More emergency-room visits put into question the cost savings. More importantly, arbitrary limits intruding into medical decision-making may impact patient safety and the quality of care I provide.
Cost containment for Medicaid needs to happen. However, the prescription drug limit is an unsafe and likely ineffective measure that needs to be repealed while better alternatives are explored.
New Sewickley Township
The writer is a pharmacist.
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