In Reply.—Drs Schillinger and Ofman describe
an unfortunate situation. Health plans that adopt restrictions on the supply
of medications to Medicaid enrollees likely believe that these restrictions
will result in lower pharmaceutical expenditures and lower costs overall.
Schillinger and Ofman argue that the health plans are mistaken. Unfortunately,
no matter who is right, Medicaid enrollees themselves will likely pay a price,
either in terms of extra time and effort to obtain medications for chronic
conditions on a monthly basis, or in terms of poor health outcomes when they
fail to receive needed medications in a timely manner. The move to managed
care offers the potential to improve health care for Medicaid enrollees by
increasing integration and accountability, but improvement in care cannot
be taken for granted.
Epstein AM. Medication Dispensing and Medicaid Managed Care—Reply. JAMA. 1998;279(12):912-913. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-12-jbk0325