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To the Editor: Dr Tamblyn and colleagues¹ report that an increase in outpatient pharmaceutical cost-sharing among the poor and elderly in Quebec was associated with a decrease in outpatient pharmaceutical utilization and an increase in adverse health events. However, these results may not be generalizable to other populations, especially the privately insured population whose outpatient pharmaceutical spending usually represents a small percentage of their income. For many working insured individuals, co-payments and drug costs are low relative to household income. All other things being equal, individuals with higher incomes are less sensitive to price increases than individuals with lower incomes.

We recently completed a study of the effects of an increase in cost-sharing for 16 783 employees (mean age, 40.9 years; age range, 19-60 years) of a large privately insured firm in the United States. The comparisons are of interest even though the form of increase differed. In our case, the . . . [Full Text of this Article]

RELATED ARTICLE

Adverse Events Associated With Prescription Drug Cost-Sharing Among Poor and Elderly Persons
Robyn Tamblyn, Rejean Laprise, James A. Hanley, Michael Abrahamowicz, Susan Scott, Nancy Mayo, Jerry Hurley, Roland Grad, Eric Latimer, Robert Perreault, Peter McLeod, Allen Huang, Pierre Larochelle, and Louise Mallet
JAMA. 2001;285(4):421-429.
ABSTRACT | FULL TEXT  

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