Copayment for pharmaceutical services in a Medicaid program.

Copayment for prescription drugs in a Medicaid drug program is an increasingly popular mechanism to finance dispensing fee increases. There is, however, reason to expect such a provision to alter physician prescribing habits. Furthermore, the copayment, although small in dollar amount, may create an economic barrier to indigent program recipients obtaining the necessary medication to maintain their well-being. A sample of pharmacy providers in the South Carolina Medicaid drug program was surveyed to ascertain their perspective toward the copayment provision. The response rate from the 200 randomly chosen practitioners was 91%. The theory that copayment creates an economic barrier to the consumption of necessary pharmaceuticals could not be supported. However, providers in high volume Medicaid pharmacies reported physicians altered their prescribing behavior to prescribe a larger quantity of doses per prescription. In general, pharmacists reported a high degree of satisfaction with the copayment provision.