According to the Des Moines Register, Iowa’s Medicaid plan has apparently decided that people with new prescriptions for psychiatric or neurological medications, unlike people with new prescriptions for pretty much any other medication, can initially only receive a 15-day supply, as opposed to a 30-day supply, of their new meds.
According to Chuck Palmer, director of the Iowa Department of Human Services, this is because doctors frequently adjust dosages of psychiatric medications shortly after prescribing them, which leads people to waste the remainder of their 30-day initial supply: “A huge number of psych meds, which are fairly expensive, go unused.”
I’m pretty skeptical of the proposition that psych meds are uniquely likely to be adjusted within 30 days of their initial prescription. In addition, many dosage changes don’t lead to wasted pills, as they can be implemented by simply taking more or fewer of the same pills in a day.
On the other hand, it does seem pretty plausible that people who are prescribed medication for depression, ADHD, or psychosis may have extra trouble getting back to the pharmacy in 15 days to refill their new prescriptions, which may not even have started to work yet by that point. It seems like any savings would primarily be from just plain making it harder to stay on medication.
Overall the implicit assumption seems to be that funding medication to people who have psychiatric or neurological problems is inherently “wasteful.”