BMJ  2003;327:1397-1400 (13 December), doi:10.1136/bmj.327.7428.1397

Education and debate

Rethinking prescribing in the United States

¹ BMJ Knowledge, London WC1H 9JR aellner@bmjgroup.com

The United States wants to increase senior citizens' access to prescription drugs at a time when spending on drugs is soaring. Is a national list of essential medicines the answer?

The first 150 words of the full text of this article appear below.

Many elderly people in the United States have no insurance cover for prescription drugs. Currently, one in four elderly people in the United States limit their drug use because of cost.¹ The US Congress recently passed a bill that partially subsidises prescriptions for elderly and disabled people while promoting their use of private health insurance plans. Previous efforts to provide drug benefits to this population have been unsuccessful, however, largely because it would be hugely expensive. One way to extend access to drugs while containing costs is to establish a limited or essential list of medicines. This article discusses the benefits of such an approach and barriers to implementation.

Rising drug costs and spending

One of the reasons that US drug spending is rising rapidly² is shifting demographics. The group aged over 65 is one of the fastest growing parts of the population. This group tends to be more chronically ill and require more drugs. . . . [Full text of this article]

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Limited or essential lists of drugs

Effects on costs

Reference pricing

Political barriers

Balancing innovation and access

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This article has been cited by other articles:

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Rapid Responses:

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Education or Debate?

Tom Sargent
bmj.com, 13 Dec 2003 [Full text]

Regarding High Prescription Prices In The US

Lloyd R Gaarder
bmj.com, 3 Jan 2004 [Full text]

Error correction in attached full report

Beth Nash
bmj.com, 14 Jul 2004 [Full text]