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To the Editor: Commentators have suggested that the new Medicare Prescription Drug Improvement and Modernization Act would cost substantially less if the federal government were allowed to directly negotiate drug prices for patients insured under Medicare.¹ In contrast, the Congressional Budget Office has concluded that this effect would be negligible and has emphasized substantial savings available through the Medicare associated private plans.² The Department of Veterans Affairs directly negotiates with pharmaceutical companies for the prices of dispensed prescriptions. We estimated the savings for a hypothetical patient if the Medicare benefit utilized direct negotiation with pharmaceutical companies similar to the approach used by the Department of Veterans Affairs.

Methods

We examined the costs of 2 equipotent evidence-based regimens, one brand-name and one generic, commonly prescribed for patients with cardiovascular disease³ (Table). First, we found the prices for our selected regimens at the Web site drugstore.com.⁴ This was chosen as a . . . [Full Text of this Article]

John M. Hayes, MD
john.hayes@med.va.gov

Heather Walczak, MS; Allan Prochazka, MD
Denver Veterans Affairs Medical Center
Denver, Colo

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