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To the Editor: Dr Monane and colleagues¹ should be applauded for their efforts to improve prescribing for older adults. Pharmaceutical benefits managers (PBMs) have access to a wealth of data and, arguably, have an obligation to intervene when they identify potentially inappropriate drug use in this population. To maximize accountability, the results of these interventions should be documented, analyzed, and communicated.²

We agree that the drugs and dosages identified by Beers³ generally should be avoided in older adults. Furthermore, physicians who choose to prescribe these agents must fully appreciate the associated risks and implement a monitoring plan to regularly review effectiveness and toxic effects. Express Scripts/ValueRx, Plymouth, Minn, encourages the application of these principles through our Seniors Program, which delivers targeted education to physicians prescribing for older adults. The program materials, delivered via mail or fax, provide referenced physician education and patient-specific pharmacy claims history. Physicians are asked to consider . . . [Full Text of this Article]

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Improving Prescribing Patterns for the Elderly Through an Online Drug Utilization Review Intervention: A System Linking the Physician, Pharmacist, and Computer
Mark Monane, Dipika M. Matthias, Becky A. Nagle, and Miriam A. Kelly
JAMA. 1998;280(14):1249-1252.
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