Medicare Drug Savings From Medical Marijuana Questioned

Medicare Drug Savings From Medical Marijuana Questioned

Research published in early July 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.

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.

But others say that any claims of medical marijuana triggering cost savings are the results of cost shifting.

"Even if Medicare may be saving money, medical marijuana doesn't come for free," said Deepak D'Souza, a professor of psychiatry at Yale School of Medicine who has researched marijuana. "I have some trouble with the idea that this is a source of savings."

Because the federal government classifies marijuana as a Schedule I drug, doctors can't technically prescribe it. 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 cost 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.

"We wouldn't say that saving money is the reason to adopt this. But it should be part of the discussion, We think it's pretty good indirect evidence that people are using this as medication," said W. David Bradford, a professor of public policy at the University of Georgia and one of the study's authors.

Kaiser Health News is a national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.