If poor, injured or elderly people are having problems obtaining prescription medicines, Ohio State law professor Timothy Jost aims to find out why.Jost recently sent out surveys to reimbursement programs such as Medicaid, Medicare and workers’ compensation, in order to review how effectively these programs cover the cost of necessary pain relievers.The questionnaire asked whether the programs list drugs excluded from coverage, if they have a method to determine who prescribes large doses of pain relievers and how well disciplinary actions are taken on doctors who excessively prescribe medications, he said. From what Jost has learned in his study, he has concluded that there are gaps in coverage.There is considerable evidence that pain is undertreated, Jost said. The reason is that physicians are hesitant to treat pain in fear of prescribing pain-killing drugs too aggressively, he said.”There are legitimate concerns. I’m just not sure how serious they are,” he said.Phil Schneider, a clinical associate professor in the College of Pharmacy, said the biggest problem with benefits is that only 10 percent of an average health plan addresses the cost of medication.”The only way to save money is to use less or cheaper drugs,” Schneider said.There are new drugs in the market that patients think they need because they are constantly exposed to advertisements, Schneider said. There is a higher increase in demand for these new drugs, but there are other products out there that are just as good, he said.The programs usually offer to cover a medication only if one can be substituted at a lower cost, Schneider said.”There is a gray zone of what constitutes medical necessity,” he said.Medicaid covers a sufficient number of pain medications, but restricts some prescriptions doctors can write, said Joe Talarico, a staff pharmacist at the Ohio State Medical Center. In general, there are not a lot of restrictions to get good pain medications on Medicaid, he said.A problem with Medicare is that the program does not cover oral medications, Talarico said.Jost, who is also a professor of health service, was one of six people nationwide whose grant proposal was chosen and funded by the American Society of Law, Medicine and Ethics.