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Thomas S. Bodenheimer, MD,MPH

JAMA. 2001;286:1762-1763.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Many clinicians have ordered a lipid panel for an elderly patient with diabetes and coronary artery disease, only to find that the statin drug prescribed 6 weeks ago has failed to lower the patient's low-density lipoprotein cholesterol level. "Are you taking your cholesterol pill every day?" the physician is likely to ask. "I hate to tell you, doc, but I just couldn't afford that pill. I never even bought it."

Recent studies indicate that lack of prescription drug coverage for Medicare beneficiaries is associated with lower use of essential medications and may lead to higher rates of adverse outcomes such as hospitalization and nursing home placement.^1-2 These studies comprise a subset of the medical literature demonstrating that imposing out-of-pocket costs on patients reduces use of medical services, especially for low-income persons, with worsening of clinical processes or outcomes. In the Rand Health Insurance Experiment, patients contributing . . . [Full Text of this Article]

Author Affiliation: Department of Family and Community Medicine, University of California, San Francisco.

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