The U.S. Medicaid program is likely paying far more than necessary for medications and not offering patients the most effective ones available, by ignoring international evidence-based lists of safe and effective medications, according to a new study by researchers at University of California, San Francisco.
The study, which compared the Medicaid program's Preferred Drug Lists in 40 states nationwide against the World Health Organization's 2009 Essential Medicines List, found that the medications that are automatically paid for by the state-run Medicaid programs vary widely from state to state, with few consistent protocols or rationales for their selection, including cost, safety or effectiveness of the medication.
Findings will be published in the American Journal of Public Health and are available online ahead of the print version, at www.ajph.org.
The WHO essential medicines concept is designed to help countries allocate limited resources to the most-needed, safest and most effective medications. The list has been updated biannually since 2002, using rigorous international standards to weigh medications' safety and proven effectiveness, according to the researchers.
In 2007, the United Nations' health organization found that 131 countries out of 151 surveyed use the WHO Essential Medicines List as a basis for their national formulary, but the United States is not among them.
"The United States has 51 different lists of medications that are paid for by Medicaid, and only a third of those medications consistently appear on the various lists," said Lisa A. Bero, PhD, a professor in the UCSF School of Pharmacy. "This research suggests that Medicaid could save significant money and also provide safer and more effective medications for patients by using a more consistent approach to deciding which drugs will be covered."
The Medicaid program currently serves 60
|Contact: Kristen Bole|
University of California - San Francisco