PILLS AND THE PUBLIC PURSE by Milton; Philip R. Lee & Mia Lydecker Silverman


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A meticulous examination of one aspect of health care--prescription drugs--that calls for special planning separate from other aspects of the health insurance debate. For one thing, the authors update the background information they provided in Pills, Profits and Politics (1974) on common drugs, the drug industry, and its regulation. They also consider how we are all affected--as patients, physicians, and pharmacists; how the groups interact; and the implications of recent changes. Patients are better and better informed, but physicians still learn much of what they know about the drugs they prescribe from drug company salesmen; pharmacists, meanwhile, are not in a position (due to time constraints, physician protest, or patient unawareness of the resource) to teach their customers about their prescriptions, or to maintain drug profiles on individuals. Finally, the authors scrutinize the major proposals for containing costs whle improving the quality of drug therapy: price controls, use of generic products, use of formularies at each institution (which limits the number of drugs of each type available, usually by cost), cost-sharing between patients and insurance plans, and the review of drug utilization to determine which products are safest and most effective. In anticipation of some sort of national drug insurance, the authors look at the experience of others (Canada, Europe), and the limited American experience; and then make some detailed recommendations for the future. They stress, realistically, that no one solution to soaring costs exists; it must take the form of a package with a variety of approaches. The last, best word on drug policy and the government.

Pub Date: June 1st, 1981
Publisher: Univ. of California Press