Designing an integrated drug benefit for the elderly.

The elderly are hit hard by high out-of-pocket expenses for medicines, but a stand-alone pharmaceutical benefit could cost the country billions and still not improve older Americans' quality of care. Such a benefit should be coordinated with patients' overall medical benefits. A systems-based pharmaceutical benefit is financially feasible through a combination of premiums and cost sharing, market-driven price reductions, and cost savings achieved through integrated managed care programs and improved outcomes.