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Designing an integrated drug benefit for the elderly.

A B King1, B H Colligen, R A Levy

  • 1Procter & Gamble Pharmaceuticals, Norwich, NY.

The Journal of American Health Policy
|June 7, 1994
PubMed
Summary

High prescription drug costs burden seniors. A coordinated pharmaceutical benefit, integrated with medical care, is financially feasible and can improve quality of care for older Americans.

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Area of Science:

  • Health Economics
  • Geriatric Medicine
  • Pharmaceutical Policy

Background:

  • Elderly individuals face significant financial strain due to high out-of-pocket prescription drug expenses.
  • Current healthcare systems may not adequately address the comprehensive needs of older adults regarding medication costs and overall care.

Purpose of the Study:

  • To evaluate the financial feasibility and potential impact of a coordinated, systems-based pharmaceutical benefit for the elderly.
  • To explore alternative models for pharmaceutical benefits that improve quality of care without prohibitive national costs.

Main Methods:

  • Analysis of financial models for a stand-alone versus integrated pharmaceutical benefit.
  • Examination of cost-sharing mechanisms, premium structures, and market-driven price reduction strategies.
  • Assessment of potential cost savings through integrated managed care and improved patient outcomes.

Main Results:

  • A stand-alone pharmaceutical benefit could incur substantial national costs without guaranteed improvements in elderly care quality.
  • A systems-based pharmaceutical benefit is presented as a financially viable approach.
  • Financial feasibility is achievable through a mix of premiums, cost sharing, price negotiations, and integrated care savings.

Conclusions:

  • Integrating pharmaceutical benefits with existing medical benefits is crucial for optimizing care for the elderly.
  • A coordinated, systems-based approach offers a financially feasible pathway to address high prescription drug costs and enhance care quality for older Americans.
  • Policy interventions should focus on integrated models rather than fragmented pharmaceutical benefits.

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