Title

Are Medicaid Closed Formularies Unethical?

Document Type

Article

Publication Date

1-1-2019

Keywords

Resource allocation, Access to care, Equitable care

Organizational Units

Sturm College of Law

Abstract

State Medicaid programs have proposed closed formularies to limit spending on drugs. Closed formularies can be justified when they enable spending on other socially valuable aims. However, it is still necessary to justify guidelines informing formulary design, which can be done through a process of decision making that includes the public. This article examines criticisms that Medicaid closed formularies limit deliberation about decisions that affect drug access and unfairly disadvantage poor patients. Although unfairness to poor patients is a risk, it is not a problem unique to Medicaid, since private insurance programs have also implemented closed formularies.



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