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 our sickest patients from obtaining medications that they need. Furthermore, physicians and patients are often unaware of the policy until their prescriptions are denied.
Many 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 of prescription limits 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 the preliminary data on the limits recently released by the Department of Public Welfare clearly show an increasing number of emergency department visits in patients denied medications. The prescription drug limit was designed to save the state money with the hope it would not impact patient care. More emergency department visits put into question the cost savings of the policy.
More important, arbitrary limits intruding into medical decision-making may impact patient safety and the quality of care we provide. Cost containment for Medicaid needs to happen, but the prescription drug limit is an unsafe and likely ineffective measure that needs to be repealed while better alternatives are explored.
The writer is a registered pharmacist.