Issue Briefs: Access to Medications

Over the past three years, every state and the District of Columbia has attempted to contain costs in its Medicaid prescription drug program1. At the time of this writing, more than 40 states have either instituted or authorized a preferred drug list; 32 states have instituted or increased copayments; and 14 states have instituted monthly prescription limits in their Medicaid programs. Moreover, most private health plans already restrict access to medications using one or more of these methods, and other state agencies, such as Departments of Corrections, are exploring restrictive policies with increasing frequency. Unfortunately, few states or private programs are using available data to thoroughly analyze the health and financial consequences of these policies.

This issue brief series is a timely and critical resource mental health stakeholders can employ in their efforts to counteract policies that threaten patient health and safety, and ultimately, fail to achieve true cost savings. The series analyzes state Medicaid prescription drug cost-containment policies and explores the range of policy options that states can employ to improve health outcomes and control costs. These five issue briefs cover different aspects of prescription drug policies, including:

1. The Case for Open Access to Medications 233kb PDF
2. State Policies That Restrict Access to Medications 95kb PDF
3. Essential Consumer Protections in Medication Policies 206kb PDF
4. Promoting Appropriate Use of Medications 229kb PDF

NMHA hopes that these issue briefs will educate mental health advocates about state Medicaid cost-containment efforts; provide examples and solutions that advocates can share with state policymakers; and serve as a tool that advocates can adapt for their public education, media outreach and advocacy needs.

NMHA Policy Positions: Access to Medications

For more information on this issue brief series or other state mental health policy issues, please contact the Advocacy Resource Center at 1-800-969-NMHA (6642), Option 6, shcrinfo@nmha.org.

1 Smith, V, Ramesh, R., Gifford, K., Ellis, E. & V. Wachino (2003). States Respond to Fiscal Pressure: State Medicaid Spending Growth and Cost Containment in Fiscal Years 2003 and 2004. Results from a 50-State Survey. Health Management Associations, Kaiser Commission on Medicaid and the Uninsured. Available: http://www.kff.org/content/2003/4137/4137.pdf

National Mental Health Association
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