Monane M, Nagle B, Kelly M A
Department of Medical Affairs, Merck-Medco Managed Care, Montvale, NJ, USA.
Geriatrics. 1998 Sep;53(9):51-4, 63; quiz 64.
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.
药物治疗仍然是医生为老年患者管理医疗状况所能提供的最具成本效益的干预措施之一。由于许多美国老年人患有多种疾病，从业者的目标是在避免重复用药或药物相互作用的同时，最大限度地合理用药。医疗保险管理式医疗计划试图通过诸如药品目录、事先授权、通用名和治疗性替代以及药物利用审查等策略，以合理的成本为老年患者提供适当的药物。然而，与药物本身一样，这些策略需要仔细关注其对个体患者的风险和益处。
