In an attempt to contain costs, 27 Medicaid programs have implemented patient-level
payment limits for medications, but the effects of these restrictions on quality of care, costs,
and health status remain largely unknown. We measured the effect of one state's limit of
three paid prescriptions per month and its replacement a year later by a $1 copayment.
Using data on 48 months of claims in the study state (New Hampshire) and a comparison
state (New Jersey), we employed time-series analysis to evaluate patient-level changes in …

In this study, Soumerai and associates compare the impact of prescription payment limits on
drug utilisation, hospital and nursing home admissions on Medicaid patients in New
Hampshire, where a 3-prescription payment cap had been enacted, and Medicaid patients
in New Jersey, where no cap existed. The authors hypothesise that a limit on prescription
reimbursement would limit drug use, resulting in poorer quality healthcare, which in turn
would lead to hospitalisation or admission to a nursing home. The patient population studied …