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Study: Medicaid Patients Can't Always Pay for Prescriptions

MAY 13, 2005 -- The Center for Studying Health System Change (HSC), a nonpartisan policy research organization, reported that in 2003 more than one-fifth of all adult Medicaid enrollees reported that they couldn't afford to get at least one prescription filled.

Although all states offer prescription drug coverage for most Medicaid beneficiaries, 22 percent of Medicaid beneficiaries aged 18 and older said they couldn't afford to get a prescription filled in the previous year, according to findings from HSC's Community Tracking Study Household Survey.

The poll was a nationally representative survey involving 46,600 people in 2003 and 60,000 people in 2001, HSC said.

The percentage of Medicaid beneficiaries reporting that they couldn't afford at least one prescription in the previous year was about the same as the comparable figure for uninsured Americans—22 percent versus 26 percent. In contrast, about 9 percent of adults with employer-sponsored health coverage said they couldn't afford a prescribed drug in the previous year.

While Medicaid cost-containment methods vary from state to state, the most common include imposing nominal co-payments, setting dispensing limits that restrict the number of prescriptions, mandating substitution of generic drugs for brand-name drugs and requiring prior authorization for certain drugs.

The HSC findings were reported in the May/June edition of the journal Health Affairs.

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