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US Medicaid drug lists cost more, deliver less
Date:6/17/2011

million low-income U.S. citizens, or about 20 percent of the population, according to the paper. It is jointly funded by the federal and state governments and is managed by the states. Each state develops its own Preferred Drug List for its fee-for-service Medicaid patients, which identifies medicines that are fully reimbursed by Medicaid without prior authorization. Prescription drug benefits are the second largest spending category for the Medicaid program.

The study set out to determine whether Medicaid patients have access to all medications listed by the WHO as essential medicines, assess how closely the state lists follow the WHO recommendations and evaluate the consistency of state lists nationwide.

At the time of the study in late 2009, only lists from 40 states and the District of Columbia could be analyzed. Nine others were not available online and Tennessee had no fee-for-service plan for its patients. Managed-care Medicaid plans follow the managed care organization's drug formulary and are not publicly available.

The group identified 369 medicines in the nine therapeutic classes that had the highest annual Medicaid reimbursements and also were addressed by the WHO list. Those include medications for asthma, depression, diabetes and hypertension, among others.

All but six of the 120 WHO medications in those categories also appeared on most of the states' lists, but their use was inconsistent across the lists. The study found that an additional 249 medicines only appeared on state lists and were not considered as the most effective and safest medications by the WHO.

"The issue is not that our patients cannot get the WHO-recommended medications, but that they are receiving a wide variety of other medications that cost more and are not always as effective or safe," Bero said. "This study suggests that if states used the World Health Organization Essential Medicines List as a starting point, it might reduce the n
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Contact: Kristen Bole
kristen.bole@ucsf.edu
415-502-6397
University of California - San Francisco
Source:Eurekalert  

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