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Report: Medicaid prescription drug use soars while private insurers see drop


Medicaid saw a big increase in prescription drug use last year, especially in states that expanded the program under the Affordable Care Act. Meanwhile, private insurers experienced a drop in prescription meds and their members also visited doctors less often, according to a new report from the IMS Institute for Healthcare Informatics.

Consumers with Medicaid in expansion states filled 25.4 percent more prescriptions in 2014 than they did the year before. But nonexpansion states only had a 2.8 percent increase in prescription medications.

That difference is "stark," Sabrina Corlette, a senior research fellow at the Center on Health Insurance Reforms at Georgetown University, told The New York Times. "It suggests that in the Medicaid expansion states, people are accessing the healthcare system. They are seeing physicians and other prescribers and getting needed drugs."

Additionally, 70 percent of individuals who signed up for a health insurance exchange plan and filled a prescription in 2014 were enrolled in a commercial plan the year before.

The IMS Institute determined that patients with diabetes were less likely to take their diabetes medication after their costs reached $30. The odds of them filling their prescription decreased even more when their costs were more than $125. That's likely the result of insurers selling more high-deductible health plans on exchanges.

However, it's hard to generalize about consumers' coverage under high-deductible plans because insurers have different ways of setting them up, Gary Claxton, a vice president at the Kaiser Family Foundation, told the Times. But he said previous studies have supported the theory that "with more cost-sharing, you get less use."

In fact, a recent Kaiser Family Foundation study found that almost 25 percent of all non-elderly Americans with private health coverage lack the financial means to pay their deductibles, FierceHealthPayer previously reported.

To learn more:
- here's the IMS report
- read The New York Times article

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Will high deductibles cost insurers more money?
Big pharma's pricing a significant factor in driving up current healthcare spending