Isabelle Nguyen

Medicaid and Medication Access Issues

Although our society has advanced greatly in the subjects of science and healthcare, there
are still people still suffering from treatable illness. One issue is the unavailability of some
medications to those who live in poverty. There are a few policies set in place to try and reduce
the amount of people in need, but there are many others who fall through the cracks. Specifically,
Medicaid is one such policy that attempts to provide medical aid to those who cant afford
regular insurance, but still has many issues and legal red tape that makes access difficult.
The inability for some to afford the medications they need is unsettling and quite tragic.
According to Joyce C. West, author of Medicaid Prescription Drug Policies and Medication
Access and Continuity: Findings From Ten States, a change in policy to co-payments made
them unable to access their medication or switch it to an inferior type that was cheaper. In the
study, researchers found that for 29.4% of patients, the physician listed a specific, clinically
indicated medication that he or she would have preferred to use but could not because of health
plan prescription drug coverage, approval issues, or issues with patient copayments(West 4).
This particular statement emphasizes the issue that is troubling society: that those in desperate
need do not have access to what they need because of monetary issues and changes in policies.
Not only is there an issue in not having access to medication, there is also an issue in
changing the medication to another version that has different effects and may negatively affect
the patient. When the policy changes and disallows a medication that is currently prescribed,
sometimes the change in medication can cause an adverse reaction and hurt the patient. One of
the changes in policy of the prescription drug utilization management. According to the study,
there was a range of 27.1% to 64.7% of patients who could not access their medications. In

Isabelle Nguyen

addition, of the adverse events that occurred during the time of the study in the ten states, 45.1 to
70.0% are strongly associated with the access problems (West).
This problem varies according to the area. In the article, a study was conducted across ten
states, ranging from the east to the west. The study focused on psychiatric patients and their
access to medication. In some states, there was significantly less access to medications in some
states in comparison to the access that the others had and also significantly more health issues in
a one area over another. I would like to research more into this area and see why there is a
disparity for the states and if there was a way to implement the policies of the states with better
medication access into the states with less access.
The study discussed the medication access of various sample groups and presented the
results of a study that spanned ten states. The study focused on the policies of ten states with
Medicaid programs. It tested how many of the sample group had problems getting their
medications and the results from those who could not. This document definitely focused on the
fact that many people are either unable to get their medications for a variety of reasons and that
those that can often get their medications changed and get adversely affected. It stresses that the
money saving measure will cost society in different ways including significant human,
economic and social costs (West 10). I believe that the authors are very concerned with the
patients and how Medicaid and its policies affect the public.
The article does not mention any solutions to the financial problems behind this issue and
focuses very heavily on the price to the people who cannot afford their medications because of
policy changes. West suggests studying the policies of New York, Texas and California as a basis
for other policies. The article suggests that these three states have policies that positively affect
medication access and reduced adverse events.

Isabelle Nguyen

As a future pharmacist, these issues are worth researching and learning about to possibly
contribute to bringing about change. If I wish to be a good pharmacist, I should want the best
medication for my patient and not have to deny him or her the best possible care because the
current policy says no. This topic interests me because I want to help people and dont only want
to help those who can afford it. I want to learn more about the intricacies of public health policies
and possibly what can be done to help improve them so that those that need help can actually get
help.
I personally have never had an issue gaining medication, but I can only imagine the
horrors of needing it, and not having it. My mother works in a hospital and occasionally brings
home stories of what happened that day. Some people were admitted for issues that could have
been avoided had they had access to medication. I believe one of the stories was of a patient who
fainted because she was prescribed insulin at a previous admittance, but she could not afford it
and so went without. Because she did not have access to a medication she so obviously needed,
she was readmitted to the hospital and injected. This adverse event could have been avoided had
she actually been able to afford insulin.
There is no one easy solution for these kinds of issues. The main problem is funding and
qualifications for being covered under government policy. Medications do cost money and it is
not easy to just supply them for free for everyone who needs it. The lgo
Joyce C. West , Ph.D., M.P.P.; Joshua E. Wilk , Ph.D.; Donald S. Rae , M.A.; Irvin S. Muszynski
, J.D.; Maritza Rubio Stipec , Sc.D.; Carol L. Alter , M.D.; Karen E. Sanders , M.S.;
Stephen Crystal , Ph.D.; Darrel A. Regier , M.D., M.P.H. (2009). Medicaid Prescription
Drug Policies and Medication Access and Continuity: Findings From Ten States.

Isabelle Nguyen

American Psychiatric Association Publishing, 1-11. September 23, 2015. Online source.
< http://ps.psychiatryonline.org/doi/full/10.1176/ps.2009.60.5.601>