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Medicare Drug Beneficiaries and Cost-Lowering Strategies—Reply
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In Reply: We strongly endorse the use of direct generic substitution and "rational prescribing" when they are based on rigorous scientific information, because these are important ways to help people manage their drug expenditures. This is based on our own finding that seniors who exceeded their drug benefit caps decreased their use of essential medications, as well as on estimates from others that 1 in 4 Medicare beneficiaries will face the "donut hole" in the new Medicare drug benefit.1 This "donut hole" represents the gap in coverage when beneficiaries’ annual drug expenditures exceed their benefit cap but are not yet high enough to qualify for catastrophic coverage. Better mechanisms to help people manage their drug costs must be found. We thank Drs Bjarnason and Kampmann for highlighting these programs in Denmark.
Currently, all 50 states in the United States allow pharmacists to make direct generic substitutions unless directly prohibited by . . . [Full Text of this Article]
Chien-Wen Tseng, MD, MPH
cwtseng@hawaii.edu
Department of Family Medicine and Community Health
John A. Burns School of Medicine
University of Hawaii
Honolulu
Carol M. Mangione, MD, MSPH
Division of General Internal Medicine and Health Services Research
David Geffen School of Medicine at UCLA
Los Angeles, Calif
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