Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr Joyce and colleagues1 found that insurance plans with either increased
co-payments or mandatory generic substitutions had lower drug costs. They
also found that such policies led to increased out-of-pocket costs for patients.
However, their outcome measure (payments made by employer) may not be correct.
Although other components of transaction data are typically well-defined in
plan summary documents (eg, pharmacy dispensing fee, contracted discount off
average wholesale price [AWP], and cost-sharing with patients), line-item
drug ingredient price data from the health plan are often subject to interpretation.
Clark BE, Garis RI. Financial Consequences of Drug Benefit Plans. JAMA. 2003;289(4):423-424. doi:10.1001/jama.289.4.423-a