It’s safe to say that W. David Bradford has marijuana on his mind.
As an economist with the University of Georgia Department of Public Administration and Policy, he has spent the last several years analyzing how medical cannabis affects prescription costs in federal programs like Medicare and Medicaid. Last year marked the publication of a study undertaken by Bradford and his daughter, Ashley C. Bradford, specifically on Medicare Part D spending. The two have now published a new study (in Health Affairs, as was the first) analyzing Medicaid spending in states where medical marijuana is legal. And once again, the results are hard to chalk up to mere coincidence.
To recap the earlier study: the Bradfords’ analysis revealed that in states where patients had access to medical cannabis, Medicare Part D prescription spending was down by $165.2 million in 2013. Medicaid is the focus of the latest study; the Bradfords estimate that the government saved around $475.8 million in 2014 across medical marijuana states. Because the total Medicare Part D drug budget was $103 billion in 2013, and the total Medicaid fee-for-service prescription budget was $23.9 billion in 2014, the reduced spending ratios come in within the same ballpark.
Analysis zeroes in on certain health conditions
Since the study’s authors were not privy to details about which patients opted for medical cannabis or why, they focused on prescription drug use for certain conditions that have been known to be treated with medical marijuana (seizure disorders, spasticity, depression, glaucoma, sleep disorders, anxiety, nausea, psychosis, and pain). The Centers for Medicare and Medicaid Services (CMS) has been keeping a record of prescription reimbursement by state for over 25 years.
What the study showed was a reduction in Medicaid fee-for-service prescription spending in more than half of those medical condition categories: an 11% decrease in meds used to alleviate pain; a 12% drop in prescriptions used to treat psychosis and seizure disorders; a 13% decline in medications used for treating depression; and a 17% drop in prescriptions used to relieve nausea. (The study’s authors did not see a correlation between medical cannabis and fewer traditional prescriptions when it came to sleep disorders, spasticity, glaucoma or anxiety.)
The former Medicare Part D study showed that seven of the nine categories saw decreases in prescription spending, as compared to five of the nine in the Medicaid analysis. In the Medicare study, the only conditions that didn’t seem to be involved in reduced prescription use thanks to medical cannabis were spasticity and glaucoma.
Potentially slashing opioid use can have staggering ramifications
“Pain is the biggest category, and nausea is also big,” Bradford told The Lund Report. “It’s odd because nausea is bigger in Medicaid and pain is a bigger issue in Medicare.” He theorized that a difference in core age groups from Medicare to Medicaid might account for that variance.
The Centers for Disease Control and Prevention (CDC) reports that 91 Americans lose their lives every day in the country’s opioid epidemic. If some patients can find pain relief in cannabis instead of opioids, medical marijuana obviously holds the potential for greater benefits than lower prescription spending alone.
Bradford is planning another medical cannabis study, this time one that explores whether the prescribing patterns of physicians are impacted in states where patients have the option of legal marijuana. He believes that marijuana should be reclassified to a Schedule II drug (or lower) so that providers could be more hands-on in recommending it and monitoring patients who are taking it. Because cannabis is still a Schedule I substance at the federal level (along with heroin and LSD), doctors can’t actually prescribe it, regardless of the state-sanctioned legality.
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