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Prescription Drug Benefits and Health Status Among Medicare Patients—Reply
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In Reply: In considering the impact of annual dollar caps on drug benefits for Medicare beneficiaries, we characterized 15 of the top 20 medications driving their drug expenditures as for the treatment of a "chronic" disease. This was to demonstrate that patients would likely require continuing medical treatment even after exhausting their yearly drug benefits. We took a conservative approach and included health conditions such as cardiovascular disease, hypercholesterolemia, and diabetes.
We thank Dr Moldawsky for pointing out that a disruption in care for depression because a patient cannot afford the cost of antidepressant medications also could be considerably detrimental to care. Without a doubt, depression is an important health problem, and in many cases patients may benefit from long-term treatment.
We did not measure medication use or health outcomes after patients exhausted benefits. Other studies, however, have found that patients often do decrease use with higher out-of-pocket drug costs.1 . . . [Full Text of this Article]
Chien-Wen Tseng, MD, MPH
Department of Family Practice and Community Health
John A. Burns School of Medicine
University of Hawaii
Honolulu
Carol M. Mangione, MD, MSPH
Department of Medicine
David Geffen School of Medicine at UCLA
Los Angeles, Calif
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Prescription Drug Benefits and Health Status Among Medicare Patients
Richard Moldawsky
JAMA. 2003;290(15):1994.
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