Access to quality patient care for the un- and underinsured is an appropriate boilerplate issue in healthcare reform. President Obama has made it a centerpiece in his efforts to drive home a cogent national healthcare access policy. Consequently, much has been said on this issue. But what about the access to mediactions for this patient population — those who rely, specifically, on state Medicaid programs to obtain the medicines they need to, um, keep them out of emergency departments unnecessarily?

According to a recent study published by the APA, those beneficiaries of state-subsidized medical assistance programs faced significant barriers when it came to obtaining medications to treat and/or manage their chronic mental illness diagnoses — leading to adverse patient outcomes.

Medicaid prescription practices, such as requiring a switch to generics; placing limits on the number or dosing of medication; requiring prior authorization; and requiring use of step therapy or fail-first protocols, were associated with a greater number of adverse events in patients, the study found. States with more prescription drug management practices in place had significantly higher medication access problems. After adjusting for patient case mix, patients with medication access problems had a 3.6 times greater likelihood of experiencing a significant adverse event. 

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