Prescribing Patterns in the New York City Medicaid Program

A sample of 5,271 legend drug prescriptions and over-the-counter pharmacy orders submitted to the New York City Medicaid Program was analyzed. The distribution of medications and supplies by therapeutic category is presented in detail, as a reference document for comparison with other pharmaceutical programs. To facilitate comparisons, the study utilized the clearly defined therapeutic categories of the Formulary of the American Society of Hospital Pharmacists. Although no other recent study of the total prescription pattern for a low-income population exists, the distribution observed basically parallels findings for general populations. Specific areas in which differences were noted relate to the structure of health care services for New York City's indigent population, and to desirable decreased prescribing of abusable items for which the New York City Medicaid Program requires prior authorization. The average cost per prescription or order ($3.79) was unexceptional, and the proportion of medications prescribed generically (13%) was equal to or larger than that found in other studies. However, the authors feel that administrative changes, combined with physician education, can greatly increase generic prescribing and thereby reduce costs significantly. A current plan to encourage generic dispensing is discussed.