Adults who are incarcerated have a higher-than-average prevalence of infectious diseases, hypertension, asthma, arthritis, mental illness, and substance use disorders, often in combination. Since departments of corrections (DOCs) are legally obligated to treat individuals in their custody, they—like all health care purchasers in this country—face the challenge of pharmaceutical prices that seem to rise constantly, and sometimes rapidly. Yet unlike the country’s two largest publicly supported health insurers—Medicaid (for eligible low-income people) and Medicare (for eligible individuals 65 years and older and people with disabilities)—relatively little is known about how each DOC purchases pharmaceuticals, what they spend for them, and what policies they adopt to govern their use.
Report: Pharmaceuticals in State Prisons (PDF)
A number of complex and interrelated elements affect the delivery and cost of pharmaceuticals in a correctional setting, including the organization of the prison system’s overall health care delivery system, its drug-purchasing strategy, its selection of preferred drugs (known as the formulary), and copayment requirements. The decisions a state makes about these questions can help improve the quality and cost-effectiveness of a state’s correctional health program and contribute to a well-coordinated and integrated state health care system.
In an effort to better understand the role of pharmaceuticals in the state correctional setting and budget, and in a state’s overall health care strategy, The Pew Charitable Trusts, in partnership with the Vera Institute of Justice, administered a survey in 2016 to each state’s department of corrections, receiving responses from every state except New Hampshire. Respondents were asked how much they spent on prescription drugs, what their highest-cost drugs were, whether they charged incarcerated adults copayments, and whether they had access to the federal Health Resources and Services Administration’s (HRSA) 340B discounted drug pricing program through an agreement with an eligible provider.
The research found:
Data-driven state policy innovations across America
How and why states strive for high-performing systems
New federal guidelines clarify and revise long-standing policies
See new research from Pew that examines correctional health care spending and performance through comprehensive 50-state assessments and other analyses.