Comprehensive medical marijuana programs have been established in over half of U.S. states, and just six states currently have no form of medical marijuana policy. More than ever, people are turning to medical marijuana as a way to relieve the symptoms associated with their medical conditions, instead of relying on traditional pharmaceuticals.
However, regardless of its spreading popularity, medical marijuana isn’t treated the same as traditional treatment options, creating a number of complicated issues, like the refusal of health insurance providers to cover the costs of doctor recommended medical marijuana.
Big Pharma is currently losing potential profit in states that have already legalized medical marijuana. Research from the University of Georgia shows that prescription medication use is down in states with established medical marijuana programs. The average doctor in these states prescribed 265 fewer doses of antidepressants, 486 fewer doses of seizure medication, 541 fewer anti-nausea doses, and 562 fewer doses of anti-anxiety medication in each year of the study. However, it was pain medication that was hardest hit, seeing an average of 1,826 fewer doses in medical marijuana states.
The researchers in the study wanted to determine just how much revenue the pharmaceutical industry has lost in medical marijuana states. In 2013, the 17 states with medical marijuana laws saved an estimated $165 million on prescription pills. Extrapolating from their findings, the team concluded that, if medical cannabis was legalized at the federal level, over $500 million would vanish from the pharmaceutical industry’s annual revenue reports.
Although medical marijuana has been taking money out of the profits of pharmaceutical companies, in the end medical marijuana is actually saving health insurance companies the hundreds of millions of dollars that they would normally payout to cover thousands of these prescription medications.
However, because medical marijuana isn’t recognized by the FDA and doesn’t possess a drug identification number, insurance companies are able to reject covering it under their plans. That means that it ends up being the patients themselves who have to pay for all medical marijuana expenses out of pocket. Therefore, in medical marijuana states across the country, while patients are footing the financial burden for their treatment, insurance companies are able to enjoy a significant positive bump to their balance sheets, saving hundreds of millions of dollars each year.
This out of pocket expense is most onerous for those living near or under the poverty line. For patients suffering from debilitating conditions, the cost of medical marijuana can be untenable based on their limited budgets.
Some dispensaries in medical marijuana states across the country have addressed this issue by using a sliding scale for struggling patients, helping to alleviate some of their high costs. In other cases, like with Washington D.C., considerations for low-income patients are proposed within medical marijuana legislation.
Washington D.C. proposed in 2013 that dispensaries within the District set aside 2 percent of their profits to successfully subsidize marijuana sales for low-income patients meeting or exceeding 200 percent of the federal poverty level. Berkeley, California, followed in similar suit in 2014, ordering dispensaries in the city to donate 2 percent of their products for those making less than $32,000 a year. Programs like this, though beneficial to low-income patients, are often the exception rather than the norm and simply use the majority of patients to subsidize medical marijuana costs for a minority of financially struggling patients.
Rather than relying on sales to patients to help fund these programs, existing health insurance providers can be tapped to cover the medical use of marijuana by these patients. The costs of covering medical marijuana treatments would be at least partially offset by the savings health insurers are already experiencing on prescription pharmaceuticals.
However, this radical step towards the normalization of cannabis as a medical treatment is unlikely until the DEA agrees to reschedule marijuana from its current place in Schedule I. Until then, health insurance providers are likely to continue to reject appeals to cover medical marijuana in the U.S.
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