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Previous Volume 350:608-613 February 5, 2004 Number 6 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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The need to manage escalating health care costs while maintaining reasonable access to care is becoming the salient challenge in U.S. health care policy. Insurance coverage is patchy and incomplete, and serious problems with access persist. The health care system has not succeeded in controlling expenditures. The cost pressures resulting from technological advances and an aging population are likely to exacerbate the problem of access.

Nowhere is concern about cost and access more pressing than in the provision of prescription drugs through state Medicaid programs. Prescription drugs are the fastest-growing component of health care spending.¹ Medicaid has been hit hard . . . [Full Text of this Article]

Pharmaceutical Costs under Medicaid

State Efforts to Obtain Greater Discounts

Supplemental-Rebate Programs

Expanded-Discount Programs

The Pharmaceutical Industry's Response

PhRMA's Cases

Maine Rx in the Supreme Court

Where Do States Stand?

Source Information

From the Department of Health Policy and Management, Harvard School of Public Health (M.M.M., D.M.S., T.A.B.); the Department of Medicine, Harvard Medical School (T.A.B.); and Brigham and Women's Hospital (T.A.B.) — all in Boston.

Address reprint requests to Dr. Brennan at Brigham and Women's Hospital, 75 Francis St., PBB4, Boston, MA 02115, or at tabrennan@partners.org.

Related Letters:

State Initiatives to Control Medicaid Drug Costs
Weiner M.
Extract | Full Text | PDF  
N Engl J Med 2004; 350:1912, Apr 29, 2004. Correspondence

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