Posted on 07/06/2016 7:19:24 PM PDT by BenLurkin
Prescription drug prices continue to climb, putting the pinch on consumers. Some older Americans appear to be seeking an alternative to mainstream medicines that has become easier to get legally in many parts of the country. Just ask Cheech and Chong.
Research published Wednesday found that states that legalized medical marijuana — which is sometimes recommended for symptoms like chronic pain, anxiety or depression — saw declines in the number of Medicare prescriptions for drugs used to treat those conditions and a dip in spending by Medicare Part D, which covers the cost on prescription medications.
Because the prescriptions for drugs like opioid painkillers and antidepressants — and associated Medicare spending on those drugs — fell in states where marijuana could feasibly be used as a replacement, the researchers said it appears likely legalization led to a drop in prescriptions. That point, they said, is strengthened because prescriptions didn't drop for medicines such as blood-thinners, for which marijuana isn't an alternative.
The study, which appears in Health Affairs, examined data from Medicare Part D from 2010 to 2013. It is the first study to examine whether legalization of marijuana changes doctors' clinical practice and whether it could curb public health costs.
The findings add context to the debate as more lawmakers express interest in medical marijuana. This year, Ohio and Pennsylvania passed laws allowing the drug for therapeutic purposes, making it legal in 25 states, plus Washington, D.C. The approach could also come to a vote in Florida and Missouri this November. A federal agency is considering reclassifying medical marijuana under national drug policy to make it more readily available.
Medical marijuana saved Medicare about $165 million in 2013, the researchers concluded. They estimated that, if medical marijuana were available nationwide, Medicare Part D spending would have declined in the same year by about $470 million. That's about half a percent of the program's total expenditures.
That is an admittedly small proportion of the multibillion dollar program. But the figure is nothing to sneeze at, said W. David Bradford, a professor of public policy at the University of Georgia and one of the study's authors.
"We wouldn't say that saving money is the reason to adopt this. But it should be part of the discussion," he added. "We think it's pretty good indirect evidence that people are using this as medication."
The researchers found that in states with medical marijuana laws on the books, the number of prescriptions dropped for drugs to treat anxiety, depression, nausea, pain, psychosis, seizures, sleep disorders and spasticity. Those are all conditions for which marijuana is sometimes recommended.
The study's authors are separately investigating the effect medical marijuana could have on prescriptions covered by Medicaid, the federal-state health insurance program for low-income people. Though this research is still being finalized, they found a greater drop in prescription drug payments there, Bradford said.
If the trend bears out, it could have other public health ramifications. In states that legalized medical uses of marijuana, painkiller prescriptions dropped — on average, the study found, by about 1,800 daily doses filled each year per doctor. That tracks with other research on the subject.
Marijuana is unlike other drugs, such as opioids, in which overdoses are fatal, said Deepak D'Souza, a professor of psychiatry at Yale School of Medicine, who has researched marijuana. "That doesn't happen with marijuana," he added. "But there are whole other side effects and safety issues we need to be aware of."
Study author Bradford agreed: "Just because it's not as dangerous as some other dangerous things, it doesn't mean you want to necessarily promote it. There's a lot of unanswered questions."
Because the federal government classifies marijuana as a Schedule I drug, doctors can't technically prescribe it. In states that have legalized medical marijuana, they can only write patients a note sending them to a dispensary.
Insurance plans don't cover it, so patients using marijuana pay out of pocket. Prices vary based on location, but a patient's recommended regimen can be as much as $400 per month. The Drug Enforcement Agency is considering changing that classification — a decision is expected sometime this summer. If the DEA made marijuana a Schedule II drug, the move would put it in the company of drugs such as morphine and oxycodone, making it easier for doctors to prescribe and more likely that insurance would cover it.
To some, the idea that medical marijuana triggers costs savings is hollow. Instead, they say it is cost shifting. "Even if Medicare may be saving money, medical marijuana doesn't come for free," D'Souza said. "I have some trouble with the idea that this is a source of savings."
Still, Bradford maintains that if medical marijuana became a regular part of patient care nationally, the cost curve would bend because marijuana is cheaper than other drugs.
Lester Grinspoon, an associate professor emeritus of psychiatry at Harvard Medical School, who has written two books on the subject, echoed that possibility. Unlike with many drugs, he argued, "There's a limit to how high a price cannabis can be sold at as a medicine." He isn't associated with the study.
And, in the midst of the debate about its economics, medical marijuana still sometimes triggers questions within the practice of medicine.
"As physicians, we are used to prescribing a dose. We don't have good information about what is a good dose for the treatment for, say pain," D'Souza said. "Do you say, 'Take two hits and call me in the morning?' I have no idea."
A close friend of mine, who, if I mentioned his big hit, you would know, was a Type l diabetic. Severe neuropathy messed him up. We’d be in the recording studio, and he’d have to leave in pain. His meds didn’t help. His son got him to take a couple of tokes, and the meds kicked in, and he was functional. Many meds add aspirin because it makes them work better. Tom is gone now, but a few tokes eased his pain. RIP Tom!
As usual, that’s where the government is screwing up.
Medical MJ is legal in AZ, but it’s about $350 an ounce. That’s if you buy it by the ounce. If you buy smaller amounts, it’s even more. Throw in the $300-400 fee to get the note and the filing fee with the state and it’s just not worth it for a lot of people.
There are *many* people here who qualify for MM, but who simply can’t afford it. Being on the Mexican border, there are plenty of options.
We need to open up the free market to shut down the drug cartels down here, but the government is driving the price too high and creating an inconvenience.
As that’s a *big* benefit of legalizing MJ (shutting down the cartels with competition) you’d think that the state would realize that they’re shooting themselves in the foot.
Or stop having seizures. Or calm the nerves to reduce pain and be able to get off opiates. Or stop muscle spasms. Or be able to sleep without PTSD-induced nightmares. Or be able to overcome ADHD and get off the uppers that the dr prescribed.
Pfizer must be thrilled.
Colorado collected $135M in taxes from $1B in sales of marijuana in 2015. That's a lot of sales for no one buying it.
http://fortune.com/2016/02/11/marijuana-billion-dollars-colorado/
Nor does your PCP. Then you don’t have to go in once every 3 months for blood work. I’ve got one who thinks she’s a Endocrinologist, doesn’t know jack about Thyroid or ‘glucose’ readings or what effects them. Or the meds that go with it or the other testing for diabetes A1C1 and Keytone testing. Scripts for the worst of the drugs for an improperly diagnosed patient, you have to have a fit to get a meter, then she gives you only 1 test strip per day. I’ve a type 2 son, he says she’s nuts he test 4 times a day or more.
Was looking at a adjustable bed with latex mattress, as memory foam is all chems and breaks down a lot faster, told I needed a ‘recommendation’ from the doc for one. What the heck, it’s just a piece of furniture that lets you get a better nights sleep. It’s no better than a recliner except it has a remote control unit. I’m paying for it, not health ins., it’s not a hospital bed after all. I could buy a high end recliner and do the same thing, only no remote control.
I can’t speak fo Colorado as I am in Washington, but believe me, the underground marjet is 10 times the iegal one.
Yikes! I hate phone keyboards...
WA collected $129M in mj taxes in 2015, similar to CO's $135M.
http://www.502data.com/
Hey if it works for you go for it, just don’t think that it’s all harmless. Losing your memory and coordination is not exactly harmless.
Pushing it as a harmless recreational drug is very irresponsible.
Thanks for pointing out that THC is not the component most people want, it’s the other stuff, like terpenes and CBD.
LOL!!! They hurt, but just don’t care anymore?
You gotta have the picture.
Government regulations is strangling this nation. I seriously doubt we will get back to a sane Constitutional Nation no matter who is elected. You have cities, counties, state and federal government controlling your lives now and they won’t let go easily.
Report: Billions in New Spending Failed to Fix VA Problems, Made Some Worse
More than 300,000 American military veterans likely died while waiting for health care — and nearly twice as many are still waiting
Yeah, thankfully Trump has mentioned several times about over regulation. Not sure how much he can do- but at least we know he doesn’t d*ck around.
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