title: Pharmacotherapy: strategies to control drug costs in managed care.
abstract: Pharmacotherapy remains one of the most cost-effective interventions physicians can provide to manage the medical conditions of older patients. Because many older Americans have multiple diseases, the practitioner's goal is to maximize appropriate drug use while avoiding duplicative or interacting medications. Medicare managed care plans seek to provide appropriate medication for the older patient at a reasonable cost through such strategies as formularies, prior authorization, generic and therapeutic substitution, and drug utilization review. Yet, like the medications themselves, these strategies require careful attention to their risks and benefits to the individual patient.
authors.affiliation: Department of Medical Affairs, Merck-Medco Managed Care, Montvale, NJ, USA.
authors.forename: M
authors.initials: M
authors.lastname: Monane
authors.forename: B
authors.initials: B
authors.lastname: Nagle
authors.forename: M A
authors.initials: MA
authors.lastname: Kelly
mesh_terms: D016527:Drug Costs; D004358:Drug Therapy / Q000191:economics / Q000592:standards*; D017723:Drug Utilization Review; D019317:Evidence-Based Medicine; D006801:Humans; D019458:Insurance Coverage; D007356:Insurance, Pharmaceutical Services; D008329:Managed Care Programs / Q000191:economics*; D006278:Medicare; D014481:United States