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January 22/29, 2003

Financial Consequences of Drug Benefit Plans

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(4):423-424. doi:10.1001/jama.289.4.423-a

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.